Dissertations / Theses: 'Telemedizin'

1

Pielach, Claudia. "Haftungsfragen in der Telemedizin /." Hamburg : Kovač, 2005. http://www.gbv.de/dms/spk/sbb/recht/toc/470616717.pdf.

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Frost, Norbert. "Gesundheitstelematik, Telemedizin, Teledermatologie : eine interdisziplinäre Gegenstandsbeschreibung /." Münster : Lit, 2000. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=008988817&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.

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Metzger, Stephan. "Rechtliche Aspekte und Perspektiven der Telemedizin : unter besonderer Betrachtung des Vertragsrechts /." Basel : Helbing Lichtenhahn, 2009. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=018885433&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.

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4

Kühnelt, Paul [Verfasser]. "Klinische Bedeutung der Telemedizin bei kardiologischen Patienten / Paul Kühnelt." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2011. http://d-nb.info/1029846944/34.

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Herrmann, Franziska Erika. "Teledermatologie versus Konsildiagnosen retrospektive Auswertung von Konsilen der Universitäts-Hautklinik Tübingen aus den Jahren 2000 bis 2002 und prospektive Untersuchung von 120 Konsilen aus dem Jahr 2003 /." [S.l. : s.n.], 2006.

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6

Zietz, Björn Patrick. "Telemedizin und Telematik im Gesundheitswesen von Entwicklungsländern : Erfahrungen und Empfehlungen /." Aachen : Shaker, 2003. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=010678022&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.

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7

Salomo, Katrin. "Akzeptanz von Dienstleistungsinnovationen : eine empirische Untersuchung am Beispiel der Telemedizin /." Lichtenberg : Harland Media, 2008. http://d-nb.info/992328640/04.

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8

Issing, Matthias Michael. "Telematik und Telemedizin zur Verbesserung der präklinischen Notfallversorgung nach Straßenverkehrsunfällen." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2006. http://dx.doi.org/10.18452/15475.

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Die Überlebenswahrscheinlichkeit der Unfallopfer nach Straßenverkehrsunfällen hängt von der Zeitspanne vom Unfall bis zur ersten suffizienten Hilfeleistung (therapiefreies Intervall) sowie von der Qualität der Erstversorgung ab. Das therapiefreie Intervall kann durch automatische Notrufsysteme (ACN) und suffiziente Laienhilfe verkürzt werden. In dieser Dissertation werden (1) Modelle zur Prognose der Verletzungsschwere von Fahrzeuginsassen für den Einsatz in erweiterten automatischen Notrufsystemen (AACN) entwickelt und (2) Anforderungen an Telemedizinsysteme zur Unterstützung von Laien bei der Durchführung von Erste-Hilfe-Maßnahmen untersucht. (1) Die Prognose der Verletzungsschwere ist für eine optimale Disposition der Rettungsmittel erforderlich. Auf der Basis der amerikanischen Unfalldatenbank NASS/ CDS und der deutschen Unfalldatenbank GIDAS werden Prognosemodelle mit multivariaten inferenzstatistischen Verfahren (decision tree, logistic regression) entwickelt, die Bedeutung einzelner Eingangsgrößen untersucht und die Leistungsfähigkeit der Modelle überprüft. Die Leistungsfähigkeit beider statistischen Verfahren stellt sich in ROC-Analysen als vergleichbar heraus. Mit den Prognosemodellen kann eine Dispositionsempfehlung erstellt werden, die heutigen Dispositionsentscheidungen auf der Grundlage eines Telefongesprächs mit dem Unfallmelder qualitativ entspricht. (2) Zur Entwicklung eines Telemedizinsystems für die Laienunterstützung wird untersucht, ob die telemedizinische Anleitung von Laien bei der Durchführung von Erste-Hilfe-Maßnahmen zu einer Erhöhung der Hilfsbereitschaft führt und welche Anforderungen ein Telemedizinsystem erfüllen muss. Dazu werden die am häufigsten indizierten Erste-Hilfe-Maßnahmen nach Verkehrsunfällen durch Auswertung der GIDAS-Datenbank identifiziert, der Stand der heutigen Laienhilfe analysiert, die erforderlichen Funktionen eines Telemedizinsystems abgeleitet und der Einfluss einer verbesserten Laienhilfe auf die Überlebenswahrscheinlichkeit bestimmt.
The probability of survival of motor vehicle accident victims depends on two factors: the time interval between the accident and the initial provision of appropriate first-aid (therapy-free interval), and the quality of the first-aid treatment. The therapy-free interval can be shortened significantly by automatic crash notification systems (ACN) and by adequate bystander first aid. In this thesis, (1) models are developed for predicting the severity of injury of vehicle occupants for use in advanced automatic crash notification systems (AACN) and (2) requirements of telemedical bystander support systems are examined. (1) The prediction of the severity of injury is needed for optimal disposition of rescue services. Therefore, prediction models are developed on the basis of the American accident database NASS/ CDS and its German counterpart, GIDAS, using multivariate inference statistical procedures (decision tree, logistic regression). In addition, the importance of individual parameters and the efficiency of these models are investigated. The performance of the two statistical procedures proves to be equal by using the ROC analyses. The prediction models allow for recommendations of rescue services that correspond in quality to contemporary dispatching decisions for rescue services on the basis of a telephone call between the individual reporting the accident and a dispatcher. (2) Concerning the development of a telemedical bystander support system, the paper examines whether the availability of telemedical guidance leads to an increase in bystander willingness to provide first aid. In order to evaluate the requirements of a telemedical system, the most frequently indicated first-aid measures after traffic accidents are identified by evaluating the GIDAS database. Furthermore, the status of assistance currently offered by bystanders is analyzed, the necessary functions of a telemedical system are scrutinized, and the influence of improved bystander assistance on the probability of accident victims’ survival is determined.

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Reichelt, Andreas. "Telemedizin als Innovation eine Technikfolgenabschätzung des Tele Home Care im deutschen Gesundheitswesen." Bayreuth Verl. PCO, 2008. http://d-nb.info/98733588X/04.

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10

Wichterich, Eric [Verfasser]. "Standardisierung in der Telemedizin. Was aus der Sicht von Ärztinnen und Ärzten für eine Einführung von Telemedizin in ihre ärztliche Tätigkeit standardisiert werden sollte / Eric Wichterich." Bielefeld : Universitätsbibliothek Bielefeld, 2020. http://d-nb.info/1217403906/34.

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11

Schultz, Carsten. "Management hochwertiger Dienstleistungen : erfolgreiche Gestaltung von Kundenbeziehungen am Beispiel der Telemedizin /." Wiesbaden : Deutscher Universitäts-Verlag, 2006. http://swbplus.bsz-bw.de/bsz254644309inh.pdf.

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12

Jacob, Norbert. "Konzept für den Einsatz von Telemedizin, telecare in einer allgemein-medizinischen Praxis." [S.l.] : [s.n.], 2002. http://deposit.ddb.de/cgi-bin/dokserv?idn=964607093.

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13

Jung, Krisitna, Frank Jassens, Krisitn Golchert, and von Gudenberg Alexander Wolff. "Telemedizin in der Stottertherapie : Vergleich einer reinen Präsenztherapie mit einem teletherapeutischen Ansatz." Universität Potsdam, 2014. http://opus.kobv.de/ubp/volltexte/2014/7154/.

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14

Kern, Christoph [Verfasser]. "Klinische Anwendung von Big Data und Telemedizin in der Augenheilkunde / Christoph Kern." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2021. http://d-nb.info/1238518850/34.

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15

Rahimian, Shaghayegh [Verfasser]. "Telemedizin : szientometrische Analysen und Evaluation der Bedeutung für das Gesundheitswesen / Shaghayegh Rahimian." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2009. http://d-nb.info/1023581795/34.

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16

Jacob, Norbert. "Konzept für den Einsatz von Telemedizin/Telecare in einer allgemein-medizinischen Praxis." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2002. http://dx.doi.org/10.18452/14725.

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Der Nutzen von Telemedizin und Telecare/Homecare ist heute nicht mehr umstritten. Es existiert eine große Anzahl von Lösungen und Konzepten. Zum Teil werden sie bereits in der Routine eingesetzt. Die Systeme sind in der Regel vom Typ "stand-alone" bzw. "Insellösung". Ansätze einer Plattformtechnologie sind bei einigen Systemen erkennbar. Gemeinsame Probleme der vorhandenen Lösungen liegen im Bereich fehlender Standardisierung von Dateninhalten und Verfahren sowie einer soliden gesetzlichen und abrechnungstechnischen Grundlage. Von diesem Zustand bis zum flächendeckenden Einsatz von Telemedizin/Telecare ist noch ein weiter Weg. Die vorliegende Arbeit beschäftigt sich vorwiegend mit einem Teilaspekt dieses breiten Themas. Es ist die Frage, wie Telemedizin und Telecare sich optimal in den Arbeitsablauf eines Allgemeinmediziners integrieren lassen. Die Analyse zeigte, dass die Probleme in folgenden Bereichen zu finden sind: * Fehlende allgemeine und internationale Telemedizin-Plattform * Fehlende zentrale elektronische Patientenakte * Unzureichende Offenheit der Praxissoftware * Unzureichende Ko-Existenz von herkömmlichen und telemedizinischen Lösungen * Unzureichende gesetzliche und abrechnungstechnische Grundlage Folgerichtig muss ein Anforderungskatalog aufgestellt werden, der hilft, diese Mängel zu beseitigen. Auf der Basis dieses Anforderungskatalogs wurde ein Konzept entwickelt, in dessen Zentrum die allgemein-medizinische Praxis steht. Im Hintergrund der Praxis ist eine auf vorhandenen Standards fußenden Plattform, die eine flächendeckende Kommunikation aller Teilnehmer ermöglicht, vom Patienten über den Arzt bis zur Fachklinik, Apotheke und Kassenärztlichen Vereinigung sowie Versicherungen. Der Anschluss der Praxissoftware an diese Plattform ist eine wesentliche Voraussetzung zur Implementierung. Ein wichtiger Bestandteil des Konzeptes ist der Vorschlag einer international anerkannten Ontologie (UMLS), die neben der Vereinheitlichung der Dateninhalte auch bei der Internationalisierung helfen wird. Hier werden die gesetzlichen Aspekte nur soweit behandelt, als sie der klaren Vorgabe der Konzeption dienen. Die Implementierung ist nicht in einem Schnellgang möglich. Der Grund liegt darin, dass hier neben den in der Regel langwierigen Gesetzgebungsprozessen eine große Anzahl von Verbänden Mitbestimmung geltend macht, deren Interessen oft in entgegengesetzte Richtungen wirken. Es wird daher notwendig sein, die Einführung erstens schrittweise und zweitens immer im Gleichschritt mit diesen Organen zu gestalten. Ist dies jedoch gelungen, eine solche Plattform zu etablieren, so ergibt sich hieraus ein breites Spektrum von Anwendungsgebieten, wie ein weltweites Gesundheitssystem, bei dem der Patient überall auf der Welt die gleiche medizinische Behandlung wie in seinem Heimatland erfährt.
Today there is no question that telemedicine and telecare/homecare can provide benefit to their users. A large number of such systems are available. Partially they are used for daily works. Normally they are stand-alone, without an underlying platform. In the last few years one can recognize the beginning of a platform technology. The most common problems of existing solutions are caused by the lack of standardisation of data items and procedures, the lack of a reliable legal basis and billing possibilities. It is a long way to go to get the telemedicine/telecare running. This document describes a sub-aspect of the large topic telemedicine/telecare. It includes the question how one can integrate telemedicine/telecare into the daily workflow of a private doctor office. The system analysis shows that problems occurring during the integration can be subdivided into following topics: * Lack of a general and international telemedicine platform * Lack of a generally accepted electronic patient record * Lack of a interoperability of the medical information systems * Lack of a harmonized co-existence of telemedicine and medical works * Lack of a legal basis and billing possibilities As a consequence of the analysis` results a catalogue of requirements must be established which provides the basis for a system concept. The central point of the concept must be the doctor office. Its background should be a set of standards which establishes the platform for the communication between every participant to the telemedicine: patients, doctors, clinics, pharmacy, medical invoice organisations and insurance companies. The most essential requirement to implement this platform is the connection of the IT equipment in private doctor offices to the applications and databases of the platform. The key feature of the proposed concept is the integration of a international accepted ontology. We recommend the UMLS concept of the NIH. UMLS provide a set of standardized terms, the so called "concepts", and the possibilities to implement multilingual applications. In this document legal aspects are discussed only if they can contribute to the construction of the platform. Due to the never ending legislative process and the opposite interest of the participants to the platform a high-speed implementation of the platform can not be expected. A stepwise implementation which continuously accompanies the legislative processes is therefore required. However based on a successful implementation of the platform the gate is open to a large range of applications in a widely used healthcare system which can provide medical care to every patient at any time and at any location - worldwide - on the same quality level like in his home country.

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17

Dierks, Christian. "Rechtliche und praktische Probleme der Integration von Telemedizin in das Gesundheitswesen in Deutschland." Doctoral thesis, [S.l.] : [s.n.], 1999. http://deposit.ddb.de/cgi-bin/dokserv?idn=959449531.

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18

Ditz, Christian. "Validierte Nutzungsanalyse zu Telemedizin und Teleteaching am Beispiel des onkologischen Kolloqiums des Tumorzentrums Regensburg e.V /." Regensburg, 2007. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000253224.

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19

Dierks, Christian [Verfasser]. "Rechtliche und praktische Probleme der Integration von Telemedizin in das Gesundheitswesen in Deutschland / Christian Dierks." Berlin : Humboldt-Universität zu Berlin, 1999. http://d-nb.info/959449531/34.

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20

Tobman, Matvey. "Integration einer Komponente für computergestütztes Ösophagustumorstaging in einen mehrstufigen telemedizinischen Decision-Support-Service im Bereich der gastroenterologischen Endoskopie." [S.l.] : [s.n.], 2004. http://deposit.ddb.de/cgi-bin/dokserv?idn=972317481.

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21

Wagner, Gero von. "Entwicklung von Methoden zur Echtzeitanalyse von EKG-Signalen mit Neuro-Fuzzy-Systemen für Anwendungsszenarien der Telemedizin." [S.l. : s.n.], 2006. http://digbib.ubka.uni-karlsruhe.de/volltexte/1000006335.

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22

Fischer, Ulrike [Verfasser]. "Ermittlung von Anforderungen an die Gestaltung einer telemedizinisch gestützten präklinischen Notfallversorgung aus Sicht der Telemedizin / Ulrike Fischer." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2013. http://d-nb.info/1031099085/34.

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23

Link, Christian. "Telemedizinische Anwendungen in Deutschland und in Frankreich eine rechtsvergleichende Untersuchung der Grundlagen und des Haftungsgefüges sowie des internationalen Privatrechts ; mit Zusammenfassung in französischer Sprache = La telemedecine en France et en Allemagne." München Utz, 2006. http://d-nb.info/985365536/04.

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24

Jansen, Alexander C. "Pharmazeutisch-technologische Entwicklung neuer Konzepte der Telemedizin zur Optimierung der Insulinsubstitution beim Typ-1-Diabetiker mit 4 Tabellen." Münster IPT-Verl, 2008. http://d-nb.info/989698718/04.

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25

Ricke, Jens. "Über die Optimierung von Waveletalgorithmen für die verlustbehaftete Kompression digitaler Röntgenbilddaten." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2001. http://dx.doi.org/10.18452/13751.

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Ziel: Eine Optimierung medizinischer Bilddatenkompression. Evaluation des Einflusses unterschiedlicher Filter auf die Bildqualität waveletkomprimierter Röntgenbilder. Material und Methode: Im Rahmen von Vorstudien Optimierung der digitalen Bildbefundung anhand von ROC-Analysen. Auswahl geeigneter Kompressionsverfahren durch methodischen und ROC-gestützten Vergleich von Wavelet- mit fraktaler und JPEG-Kompression. Im Rahmen der Hauptstudie ROC-basierter und statistischer Vergleich von 4 unterschiedlichen Waveletfiltern verschiedener Komplexität mittels Prüfkörper für niedrigfrequente, gemischt-frequente und hochfrequente Bildinformation im schwellenwertnahen Bereich. Ergebnisse: Durch Einsatz unterschiedlicher Filter insbesondere im Niedrigfrequenzbereich entstehen signifikante Unterschiede des Rekonstruktionsergebnisses der Röntgenbilder. Trotz eines partiell uneinheitlichen Ergebnisses der visuellen Analyse fanden sich Vorteile für komplexere Filter. Für Details im hochfrequenten Bereich finden sich kaum signifikante Unterschiede. Schlußfolgerungen: Die durch die ROC-Analyse erhobenen Ergebnisse korrelierten in keiner Weise mit den gleichzeitig mathematisch erhobenen PSNR-Werten. Ursache hierfür ist, daß die Reduktion des Bildrauschens durch die Waveletkompression in der PSNR als negative Einflußgröße abgebildet wird. Bei medizinischen Röntgenbildern führt jedoch die Minimierung des Bildrauschens zu einer erhöhten Erkennbarkeit von Details insbesondere im schwellenwertnahen Bereich. Entsprechend verbesserten sich die Ergebnisse der schwellenwertnah durchgeführten ROC-Analyse ungleichsinnig zu den PSNR-Werten. Eine detaillierte Beschreibung des Einflusses der Komplexität von Waveletfiltern auf die Rekonstruktionsqualität medizinsicher Bilder findet sich im Diskussionsteil der Studie.
Aim: Optimisation of medical image compression. Evaluation of wavelet-filters for wavelet-compression. Materials and methods: Optimisation of image review applying ROC analysis. Analysis of medical image compression methods comparing wavelet-compression, fractal compression and JPEG by ROC analysis. Evaluation of 4 different wavelet-filters with different complexity applying phantoms for low frequency, high and mixed frequency information. Results: Application of filters with different complexity results in significant variations in the quality of image reconstruction after compression specifically in low frequency informatiin. Filters of high complexity proved to be advantagous despite of heterogenous results during visual analysis. For high frequency details, complexity of filters did not prove to be of significant impact on image quality after reconstruction. Conclusions: Results of ROC analysis did not correspond with PSNR values. Reduction of image noise in reconstructed images by wavelet-filtering is expressed negatively in PSNR values. In medical images, reduction of image noise enhances detection specifically of low contrast details. A detailed discussion of the influence of filter complexity on the reconstruction quality of medical images can be found in the discussion section of the study.

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Biskup, Karsten Günter. "Mobiles Kommunikationssystem zur postoperativen ambulanten Wundbetreuung /." Aachen : Shaker, 2008. http://d-nb.info/989363074/04.

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Worms, James [Verfasser], Heinrich [Akademischer Betreuer] Körtke, and Nikolaus [Akademischer Betreuer] Büchner. "Lebensqualität chronisch herzinsuffizienter Patienten unter telemedizinischer Basisversorgung durch das Institut für angewandte Telemedizin (IFAT) / James Worms. Gutachter: Heinrich Körtke ; Nikolaus Büchner." Bochum : Ruhr-Universität Bochum, 2016. http://d-nb.info/1082425664/34.

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Jacob, Norbert [Verfasser], J. [Gutachter] Szymas, K. [Gutachter] Kayser, and R. [Gutachter] Bollmann. "Konzept für den Einsatz von Telemedizin/Telecare in einer allgemein-medizinischen Praxis / Norbert Jacob ; Gutachter: J. Szymas, K. Kayser, R. Bollmann." Berlin : Humboldt-Universität zu Berlin, 2002. http://d-nb.info/1207625841/34.

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Janssen, Frank [Verfasser], René [Akademischer Betreuer] Handschu, and René [Gutachter] Handschu. "Telemedizin in der allgemeinen Neurologie: Einsatz der audiovisuellen Fernuntersuchung im Rahmen des Hintergrunddienstes im Akutkrankenhaus / Frank Janssen ; Gutachter: René Handschu ; Betreuer: René Handschu." Erlangen : Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 2019. http://d-nb.info/1197905030/34.

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Bayer, Gudrun. "Vergleich von drei unterschiedlichen Telepathologiesystemen zur primären histologischen Schnellschnittdiagnostik auf der Grundlage einer retrospektiven Studie." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2005. http://dx.doi.org/10.18452/15233.

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Ziel der vorliegenden Arbeit ist es, die Frage nach Eignung der Technik, des Aufwands, der Schulung und der Vor- und Nachteile eines Einsatzes der Telepathologie in der Schnellschnitt-Diagnostik zu analysieren. Weltweit wurden verschiedene Telepathologiesysteme entwickelt, die zum Teil für den Schnellschnitt verwendet werden können. Auch an der Charité entstanden mit dem 1.ATM-System, 2.dem TPS-System und 3.dem TELEMIC-System, drei technisch völlig unterschiedliche Systeme. Diese Systeme wurden anhand einer retrospektiven Studie hinsichtlich ihrer Einsatzfähigkeit in der telepathologische Schnellschnitt-Diagnostik untersucht. Um die Systeme untereinander vergleichen zu können, wurden 124 histologische Schnellschnittpräparate aus dem Jahr 1999 herausgesucht (ausschließlich Brustgewebe), die von vier erfahrenen Pathologen mit jedem System erneut bearbeitet wurden. Qualitativ wurden mit dem ATM- und dem TPS-System gleichwertige Ergebnisse wie in der konventionellen Schnellschnitt-Diagnostik erreicht. Das TELEMIC-System war qualitativ aufgrund der hohen Rate von Rückweisungen den anderen Systemen und dem konventionellen Schnellschnitt deutlich unterlegen. Bei den Diagnosezeiten zeigte sich eine leichte Unterlegenheit des TPS-Systems gegenüber dem konventionellen Schnellschnitt. Da es jedoch insbesondere als Möglichkeit der Ferndiagnose eingesetzt wird, fallen die bei der konventionellen Schnellschnitt-Diagnostik nötigen Transportzeiten durch einen Kurier weg. Das ATM-System und das TELEMIC-System sind auch ohne Zurechnung der Transportzeiten zeitlich zum konventionellen Schnellschnitt vergleichbare Systeme.
Target of the available work is it, the question about suitability of the technique, the expenditure, to analyze the training and the pro and cons of an application of the Telepathologie on fresh frozen diagnostics. World-wide different Systems for telepathology were developed, which can be used partially for the fresh frozen diagnostics. At the Charité were developed three technically completely different systems: 1.ATM-System, 2.TPS system and 3.TELEMIC system, These systems were examined on the basis a retrospective study regarding their serviceability on telepathologische fresh frozen diagnostics. In order to be able to compare the systems among themselves, 124 histological fresh frozen preparations were picked out from the year 1999 (excluding chest tissues), which were again processed by four experienced pathologists with each system. Qualitatively with ATM and TPS system equivalent results as on were achieved conventional fresh frozen diagnostics. The TELEMIC system was qualitatively inferior for the other systems and the conventional fresh frozen diagnostics due to the high rate of rejections. With the diagnostic times an easy inferiority of the TPS system showed up in relation to the conventional fresh frozen diagnostics. Since it is used however in particular as possibility of the remote diagnostics, the feed times necessary with the conventional fresh frozen diagnostics are omitted by a courier. The ATM system and the TELEMIC system are also without addition of the feed times temporally to the conventional fresh frozen diagnostics comparable systems.

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Zerna, Charlotte, Timo Siepmann, Kristian Barlinn, Jessica Kepplinger, Lars-Peder Pallesen, Volker Pütz, and Ulf Bodechtel. "Association of time on outcome after intravenous thrombolysis in the elderly in a telestroke network." Sage, 2016. https://tud.qucosa.de/id/qucosa%3A35636.

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Background: Recent studies showed that the safety and benefit of early intravenous (IV) thrombolysis on favourable outcomes in acute ischemic stroke are also seen in the elderly. Furthermore, it has shown that age increases times for pre- and in-hospital procedures. We aimed to assess the applicability of these findings to telestroke. Methods: We retrospectively analysed 542 of 1659 screened consecutive stroke patients treated with IV thrombolysis in our telestroke network in East-Saxony, Germany from 2007 to 2012. Outcome data were symptomatic intracranial hemorrhage (sICH) by ECASS-2-criteria, survival at discharge and favourable outcome, defined as a modified Rankin scale (mRS) of 0–2 at discharge. Results: Thirty-three percent of patients were older than 80 years (elderly). Being elderly was associated with higher risk of sICH (p¼0.003), less favourable outcomes (p¼0.02) and higher mortality (p¼0.01). Using logistic regression analysis, earlier onsetto-treatment time was associated with favourable outcomes in not elderly patients (adjusted odds ratio (OR) 1.18; 95% CI 1.03–1.34; p¼0.01), and tended to be associated with favourable outcomes (adjusted OR 1.13; 95% CI 0.92–1.38; p¼0.25) and less sICH (adjusted OR 0.88; 95% CI 0.76–1.03; p¼0.11) in elderly patients. Age caused no significant differences in onset-to-doortime (p¼0.25), door-to-treatment-time (p¼0.06) or onset-to-treatment-time (p¼0.29). Conclusion: Treatment time seems to be critical for favourable outcome after acute ischemic stroke in the elderly. Age is not associated with longer delivery times for thrombolysis in telestroke.

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Dalquen, Peter, Prince Spasenija Savic, Peter Spieler, Dietmar Kunze, Heinrich Neumann, Serenella Eppenberger-Castori, Heiner Adams, Katharina Glatz, and Lukas Bubendorf. "Making Cytological Diagnoses on Digital Images Using the iPath Network." Karger, 2014. https://tud.qucosa.de/id/qucosa%3A70580.

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Background: The iPath telemedicine platform Basel is mainly used for histological and cytological consultations, but also serves as a valuable learning tool. Aim: To study the level of accuracy in making diagnoses based on still images achieved by experienced cytopathologists, to identify limiting factors, and to provide a cytological image series as a learning set. Method: Images from 167 consecutive cytological specimens of different origin were uploaded on the iPath platform and evaluated by four cytopathologists. Only wet-fixed and well-stained specimens were used. The consultants made specific diagnoses and categorized each as benign, suspicious or malignant. Results: For all consultants, specificity and sensitivity regarding categorized diagnoses were 83–92 and 85–93%, respectively; the overall accuracy was 88–90%. The interobserver agreement was substantial (κ = 0.791). The lowest rate of concordance was achieved in urine and bladder washings and in the identification of benign lesions. Conclusion: Using a digital image set for diagnostic purposes implies that even under optimal conditions the accuracy rate will not exceed to 80–90%, mainly because of lacking supportive immunocytochemical or molecular tests. This limitation does not disqualify digital images for teleconsulting or as a learning aid. The series of images used for the study are open to the public at http://pathorama.wordpress.com/extragenital-cytology-2013/.

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Gomes, Daniel Oliveira. "Implantação De Um Serviço De Telediagnóstico De Lesões Bucais Nos Centros De Especialidades Odontológicos (CEOs) Do Estado De Pernambuco." Universidade Federal de Pernambuco, 2009. https://repositorio.ufpe.br/handle/123456789/17106.

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Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-06-14T14:29:57Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) trab_mestrado_daniel_telediagnostico.pdf: 1048169 bytes, checksum: 7ff9a35dbc7feae74298370779c671ec (MD5)
Made available in DSpace on 2016-06-14T14:29:57Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) trab_mestrado_daniel_telediagnostico.pdf: 1048169 bytes, checksum: 7ff9a35dbc7feae74298370779c671ec (MD5) Previous issue date: 2009-08-31
Objetivo: Pernambuco atualmente oferece poucas unidades especializadas em estomatologia. O objetivo do presente trabalho foi desenvolver e verificar a funcionalidade de um sistema de telediagnóstico de doenças orais no estado de Pernambuco. Métodos: Quinze computadores e a mesma quantidade de câmeras digitais foram distribuídos em centros secundários de saúde onde Cirurgiões-Dentistas foram encorajados a visitarem um website e enviarem imagens dos seus pacientes que apresentassem lesões orais para avaliação à distância por dois profissionais com experiência em estomatologia. Um formulário de feedback com opiniões dos dentistas e pacientes também foi enviado. Resultados: Entre 325 pacientes, 313 (96,31%) acharam o procedimento de tirarem fotos de suas bocas bastante confortável, 265 (81,5%) ficaram satisfeitos em ver o interior de suas bocas e 288 (88,62%) acharam o procedimento útil no entendimento dos seus problemas clínicos. Foi estabelecida uma concordância entre os avaliadores e um correto diagnóstico final em 195 (60%) casos. Em 98 (30,16%) casos somente um avaliador acertou a hipótese diagnóstica sugerida à distância. Em 26 (8%) dos casos nenhum avaliador acertou o diagnóstico. 94,44% dos cirurgiões-dentistas consideraram que o auxílio do centro de referência contribuiu para os seus conhecimentos em relação à desordem/doença e acreditaram que o processo de telediagnóstico evita um encaminhamento desnecessário do paciente Conclusão: o telediagnóstico de doenças orais provou ser um modo viável de se evitar algum encaminhamento desnecessário de pacientes.
Objective: Pernambuco, located in Northern Brazil currently offers few oral medicine specialized units. Based upon this, the aim of the present study was to develop and verify the functionality of a telediagnosis system of oral diseases in Pernambuco state. Methods: fifteen computers and the same amount of digital cameras were distributed to secondary health care centers. Dentists were then encouraged to visit a website and send pictures of their patients who presented oral lesions. A feedback form with dentists and patients opinions was also sent. Results: Among 325 patients, 313 (94.3%) found the procedure of recording images of their mouth very comfortable, were happy to view the inside of their mouths 265 (81,5%), and found the procedure generally useful in understanding their clinical problem (288 out of 325 individuals (88%). In 195 (60%) of the instances an agreement between examiners and a correct final diagnosis was established; only one consultant made a correct diagnosis in 104 of the cases (32%); and neither consultants established a correct diagnosis in only 26 cases (8%). 94,44% of dentists considered that the help of a specialized center contributed to the improvement of their knowledge concerning oral diseases and believed that the telediagnosis system avoided unnecessary referrals. Conclusion: telediagnosis of oral diseases proved a feasible way of avoiding some unnecessary referrals.

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Linngrön, Laura Vivien [Verfasser], Norbert [Akademischer Betreuer] Hosten, Michael [Gutachter] Jünger, Norbert [Gutachter] Hosten, and Carsten Oliver [Gutachter] Schmidt. "Telemedizin: „Kann ein ärztliches Aufklärungsgespräch per Videotelefonie die Aufklärung des Patienten von Angesicht zu Angesicht ergänzen?“ / Laura Vivien Linngrön ; Gutachter: Michael Jünger, Norbert Hosten, Carsten Oliver Schmidt ; Betreuer: Norbert Hosten." Greifswald : Universität Greifswald, 2021. http://d-nb.info/1232406376/34.

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Auerbach, Holger. "Gesundheitsökonomische Evaluation eines Telemedizinsystems für die präklinische Notfallrettung bei Verkehrsunfällen in Deutschland." Doctoral thesis, Humboldt-Universität zu Berlin, Medizinische Fakultät - Universitätsklinikum Charité, 2006. http://dx.doi.org/10.18452/15467.

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Aufgabenstellung: Die Europäische Kommission strebt an, die Zahl der Getöteten im Straßenverkehr in der EU bis zum Jahr 2010 zu halbieren, unter anderem durch Einsatz von Telemedizin in der präklinischen Notfallrettung. Ziel dieser Arbeit ist die Untersuchung der Kosten-Wirksamkeit von Telemedizinsystemen für die präklinische Notfallrettung bei Verkehrsunfällen in Deutschland. Methodik: Aus Sicht der Gesellschaft und der Krankenkassen werden drei Varianten eines Telemedizinsystems mit dem Status Quo in Deutschland, das heißt dem "Nicht-Einsatz von Telemedizin" in der präklinischen Notfallrettung, verglichen. Die Analyse erfolgt auf Basis retrospektiv erhobener Daten für einen Zeithorizont von zehn Jahren. Berücksichtigt werden Systemkosten, Kosten der Personenschäden und Strukturkosten des Rettungsdienstes. Diese werden diskontiert und nicht inflationsbereinigt. Der Nutzen wird mittels gewonnener Lebensjahre durch die Verkürzung des therapiefreien Intervalls und die Verbesserung der Laienhilfe gemessen. Aufgrund der Uneinheitlichkeit der Daten werden Annahmen und Abschätzungen getroffen. Ergebnis: Im Basisergebnis ist der Kosten-Wirksamkeits-Quotient für die Variante "Telemedizin für Laienhelfer" (299.366 Euro pro gewonnenes Lebensjahr) höher als für die Variante "Automatische Unfallmeldung" (247.977 Euro pro gewonnenes Lebensjahr). Den besten Kosten-Wirksamkeits-Quotient erzielt die Vollausstattung mit 239.524 Euro pro gewonnenem Lebensjahr. Im Rahmen von multivariaten Sensitivitätsanalysen (best und worst case scenario) wird festgestellt, dass eine Senkung der Systemkosten die Gesamtkosten überproportional reduziert und dass durch eine schnelle Marktdurchdringung der Kosten-Wirksamkeits-Quotient des Telemedizinsystems deutlich verbessert werden kann. Fazit: Für alle drei Varianten des Telemedizinsystems werden hohe Kosten pro gewonnenes Lebensjahr erwartet. Eine Einführung dieser Systeme erscheint nur in einer abgestimmten europäischen Vorgehensweise realistisch.
Objective: Since the European Commission set a goal of reducing the number of road accident deaths across the EU by 2010 to one half, the use of telemedicine for pre-clinical traffic accident emergency rescue is very high on the agenda. The purpose of this study is to assess the cost-effectiveness of telemedical devices for pre-clinical traffic accident emergency rescue in Germany. Methods: Three telemedical devices are compared from the perspective of society and health insurance with baseline assumptions in Germany, i.e. the non-application of telemedicine in pre-clinical emergency rescues. The analysis is based on retrospective statistical data covering a period of ten years. Costs resulting from telemedical device, personal injury, wasted journeys and erroneous dispatching of rescue services are discounted and not adjusted for inflation. The outcome is measured in terms of "life years gained" by reducing therapy-free intervals and improvements in first-aid provided by laypersons. Due to the uncertainty of data, certain assumptions and estimates are necessary. Results: In the base case scenario the cost-effectiveness ratio of the device "Telemedicine for laypersons" (Euro 299,366 per life year gained) would be higher than of the "Automatic Accident Alert" (Euro 247,977 per life year gained). The full equipment device has the best cost-effectiveness ratio (Euro 239,524 per life year gained). Multi-way sensitivity-analysis with best and worst case scenarios show that decreasing costs of telemedical device would disproportionately reduce total costs, and that rapid market penetration would largely increase the cost-effectiveness ratio of the devices. Conclusion: The net costs per life year gained in the application of the three telemedical devices are estimated as quite high. The implementation of the devices seems only realistic as part of a larger European co-ordinated initiative.

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Miot, Hélio Amante. ""Desenvolvimento e sistematização da interconsulta dermatológica a distância"." Universidade de São Paulo, 2005. http://www.teses.usp.br/teses/disponiveis/5/5144/tde-05092005-164704/.

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Para analisar a efetividade da teledermatologia assistencial a partir de fotografias digitais de lesões, avaliou-se a sistematização de aspectos técnicos, morfológicos (maculoso, relevo e palpatório) e de representatividade clínica (típico, moderado e atípico). Verificou-se que o comprometimento da qualidade técnica, a morfologia palpatória e menor tipicidade clínica devem ser suplementados pela descrição das lesões e pelas informações clínicas para aumentar sua acurácia diagnóstica. Desenvolveu-se um sistema de interconsulta dermatológica à distância e constatou-se que seu desempenho diagnóstico foi comparável à consulta presencial, devendo ser consideradas todas as hipóteses diagnósticas elaboradas, além da principal
To analyze the effectiveness of a teledermatology system, the systematization of digital photographs from cutaneous lesions on technical quality, morphologic and clinical aspects was performed. The study showed that unsatisfactory technical quality, palpatory morphology and less typical lesions should be supplemented by clinical description of the lesions and patient information to increase diagnostic accuracy. The dermatologic Internet-based teleconsultation system has diagnostic performance comparable to face-to-face consultation, and all the hypotheses, not only first one, should be considered at virtual diagnostic evaluation

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Lazzarini, Claudio Luiz. "Análise da confiabilidade do telediagnóstico por imagens dinâmicas em laringologia." Universidade de São Paulo, 2004. http://www.teses.usp.br/teses/disponiveis/5/5143/tde-08102014-151100/.

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The present study aims to establish the level of diagnostic reliability provided by the transmission of a videolaryngoscopy by videoconference (VC), evaluating the quality of the transmitted images and its impact on diagnoses. Two DVDs with 60 laryngoscopy (30 fiberscopies and 30 telescopies) images, corresponding to 30 original and 30 transmitted by VC, were evaluated by 6 laryngologists who answered a questionnaire on the quality of the selected images (scores from 0 to 3) and on the diagnoses of the related disease. A third DVD with 26 pairs of images, an original and a VC, or two original, was also analyzed by the examiners who had to select which image presented the best quality, which corresponded to the VC image, and the possible impact of such differences on the quality of diagnoses. A high level of agreement (K = 0.911) was found among the examiners in relation to the identification of the VC (96,15% of accuracy) and to the best quality of the original image (K = 0,850). Although a partial agreement has been found among the examiners (K = 0,371), diagnoses was not jeopardized by the quality of the VC image in 75,64% of the cases. Original videotelescopy images (83,33% very good) showed the best quality and videofiberscopy VC the worst (36,66% very good and good). A high degree of correctness was found for the diagnoses by VC images (86,67% by fiberscopy and by telescopy). Consequently, the use of a VC to transmit videolaryngoscopy images has proved to be efficient for the remote diagnoses of larynx diseases

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Khouri, Sumaia Georges El. "Telemedicina : análise da sua evolução no Brasil." Universidade de São Paulo, 2003. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-24102007-143128/.

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O presente estudo consiste em descrever e analisar a evolução da Telemedicina no Brasil, abrangendo as experiências efetivamente implantadas até dezembro de 2000. Várias instituições no país têm adotado programas de telemedicina, tais como hospitais, laboratórios de análises clínicas, clínicas especializadas em realização de eletrocardiogramas à distância, universidades, o Exército e o próprio Governo. Cada uma das experiências tem diferentes objetivos e não há nenhuma integração entre elas. As aplicações estudadas variam desde aquelas que requerem uma estrutura tecnológica simples como a realização de eletrocardiogramas à distância, até outras mais sofisticadas tecnologicamente como a realização de teleconferências com transmissão de imagens clínicas para segunda opinião médica e monitoração remota de leitos. Para a realização do estudo foram feitas entrevistas com os responsáveis pelos programas e um levantamento de dados em publicações especializadas. As conclusões apontam para a falta de coordenação entre os modelos adotados, para a resistência cultural relativa à informática médica e à telemedicina e para o papel tímido do Governo no fomento da telemedicina.
The present study consists in describing and analyzing the evolution of Telemedicine in Brazil, comprehending the experiences established until December 2000. Several institutions in the country use telemedicine programs, as hospitals, pathology analysis clinics, remote electrocardiograms clinics, universities, the Brazilian Army and the federal Government. Each experience has its own goals and there is no integration among them. The telemedicine programs comprehend a wide range of applications: while some require a plain technological structure as remote electrocardiograms, others demand more sophisticated resources as teleconferences with clinical images transmission and remote bedside monitoring. To accomplish this study it was necessary to conduct interviews with the leaders of the projects and also data mining in specialized publications. The conclusions indicate that there is lack of coordination among the experiences, that there is a cultural resistence both to medical informatics and telemedicine, and the faint Goverment role in stimulating telemedicine.

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Rugieniūtė, Asta. "Telemedicinos panaudijo galimybių įvertinimas Kauno medicinos universiteto klinikų padalinių vadovų požiūriu." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2008. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2008~D_20080619_145428-37562.

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Darbo tikslas – įvertinti KMUK padalinių vadovų nuomonę apie telemediciną bei jos taikymo galimybes Lietuvoje. Tyrimo metodika: KMUK vadovaujamą darbą dirbančių gydytojų (klinikų, skyrių, sektorių vadovų) anoniminė anketinė apklausa vyko 2008 metų sausio –vasario mėnesiais. Anketos buvo išdalintos visiems 128 respondentams. Statistinėje analizėje naudota 101 teisingai užpildyta anketa. Atsako dažnis 78,9 proc.. Rezultatai. Geriausiai su telemedicinos taikymo galimybėmis susipažinę klinikų vadovai. Respondentų nuomone, radiologija, oftalmologija ir kardiologija – sritys, kuriose telemedicina galėtų būti plėtojama labiausiai. 23,8 proc. respondentų telemedicinos plėtros galimybes KMUK įvertintos palankiai. Galimybės plėtoti telemediciną Lietuvos mastu buvo vertinamos atsargiau: dauguma (39,6 proc.) apklaustųjų manė, jog kol kas tam nėra pakankamų galimybių. Svarbiausi veiksniai, skatinantys sėkmingą telemedicinos diegimą Lietuvoje: gydytojų specialistų noras ir pastangos dirbti novatoriškai, telemedicinos metodų ir priemonių kūrimas bei taikymas praktikoje, teisinės bazės, susijusios su šia sritimi, tobulinimas. Pagrindinės kliūtys, trukdančios sėkmingai plėtoti telemedicinos paslaugas - kompiuterinio raštingumo stoka vyresnio amžiaus respondentų tarpe, nepakankami užsienio kalbų įgūdžiai, darbo aplinkoje esančios nepalankios techninės galimybės naudoti telemediciną bei informacijos apie informacines bei telekomunikacines technologijas bendrai ir informacijos apie... [toliau žr. visą tekstą]
Aim of the aim. To evaluate the opinion of the heads of the departments of Kaunas University Hospital on telemedicine and the possibilities of its application in Lithuania. Methods. Anonymous survey of the heads of the departments of Kaunas University Hospital was carried out in January and February, 2008. 128 heads of the department were distributed. 101 questionnaires were filled in correctly and were used for a statistical data analysis. The frequency response 78.9%. Results. The heads of different clinics of Kaunas University Hospital knew the possibilities of using telemedicine. The primary fields of medicine where the potential use of telemedicine could be developed include radiology, ophthalmology and cardiology. 23.8% of respondents thought that there were enough options to develop telemedicine in Kaunas University Hospital, whereas the options to develop it in Lithuania were assessed moderately. Many respondents (39.6 %) thought that there was not enough potential to do that. The most important factors in developing telemedicine in Lithuania were: wishes and efforts of doctors to work in a different way, the establishment and use of telemedicine’s methods and devices in practice and the improvement of telemedicine law. The main barriers to the development of telemedicine in Lithuania are: insufficient computer and foreign languages skills, inadequate technologies and the lack of knowledge about information and telecommunications technologies and the shortage of... [to full text]

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Campos, Karis de. "Construção de um material educativo na orientação do deficiente auditivo idoso." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/25/25143/tde-05072011-092429/.

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Introdução: O envelhecimento da população é um fenômeno que tem ocorrido mundialmente, inclusive no Brasil, caracterizado por alterações físicas, cognitivas e sensoriais. Nesse contexto é possível verificar alterações sensoriais importantes como a deficiência auditiva, onde o uso do Aparelho de Amplificação Sonora individual (AASI) tem como proposta minimizar os efeitos da deficiência auditiva propiciando o maior aproveitamento da audição residual. No entanto, a dificuldade de manipulação do AASI é um dos fatores que fazem com que o indivíduo deficiente auditivo protele ou abandone o uso. Iniciativas utilizando Teleducação tem tido êxito na orientação de indivíduos na área da saúde, incluindo a Fonoaudiologia. Portanto, é necessário o desenvolvimento de projetos que auxiliem o deficiente auditivo idoso no processo de adaptação do AASI. Objetivo: avaliar o DVD Conhecendo e Aprendendo sobre o meu Aparelho Auditivo (Vol. 1) no processo de adaptação do AASI. Metodologia: A metodologia foi dividida em 2 etapas de desenvolvimento. Na primeira etapa o projeto foi dividido em duas fases, senda uma de avaliação e outra a reestruturação do material didatico. Na primeira fase o DVD foi, primeiramente, avaliado por 22 fonoaudiólogos e por 25 idosos usuários de AASI. Na segunda fase, as sugestões feitas pelos avaliadores foram analisadas para a reestruturação do referido DVD volume 1. A segunda etapa consistiu na verificação da eficácia da nova versão do DVD junto aos indivíduos deficientes auditivos idosos novos usuários de AASI, com um grupo controle, composto por 14 indivíduos, que receberam apenas as orientações fonoaudiológicas e o grupo experimental, composto por 13 indivíduos, que além das orientações fonoaudiológicas, também recebeu o material didático em DVD volume 2. A eficácia da versão do DVD foi mensurada por meio da utilização do questionário PHAST, o qual foi aplicado nos grupos E e F. Resultados: Na primeira etapa os avaliadores sugeriram atualização dos modelos de AASI retroauricular, inserção do tempo de ativação da pilha e menor velocidade de fala e legendas. A reestruturação do material didático em DVD foi realizada por meio do financiamento da FAPESP, que possibilitou a contratação de uma produtora para realizar o trabalho. Houve reestruturação do roteiro, das filmagens e das edições do vídeo. Quanto à segunda etapa, não houve diferença estatisticamente significante entre a facilidade/dificuldades de manuseio encontradas nos grupos controle e experimental. A avaliação feita pelo Grupo experimental sobre o quanto o DVD volume 2 ajudou na compreensão dos conteúdos sobre o AASI, a maioria da amostra relatou que esse ajudou muito em todos os pontos avaliados. A menor classificação foi satisfatória para os aspectos abordados no DVD, não havendo diferença estatisticamente significante quando comparado ao grupo de antigos usuários de AASI. Discussão: O material didático foi avaliado, sendo sua reestruturação respaldada em estudos voltados para elaboração de materiais didáticos à distância. Todas as dificuldades encontradas pelos grupos controle e experimental corroboraram com a literatura. As avaliações feitas pelo grupo experimental mostrou o elevado grau de satisfação com o DVD Volume 2. Conclusões: O DVD Conhecendo e Aprendendo sobre o meu Aparelho Auditivo volume 2 foi avaliado, se mostrando eficaz no auxílio de indivíduos idosos novos usuários de AASI retroauricular
Introduction: The high rate of aging is a phenomenon that has occurred worldwide, including Brazil and the process leads to physical, cognitive and sensory. One change is the sensory hearing loss, which may cause the wearer to isolation. The hearing aids (HA) are used to minimize the effects of hearing loss producing good results. However, the difficulty in handling the hearing aid is one of the factors that make a person deaf procrastinate or abandon the use. Teleducation initiatives have been successful using the instruction of individuals in health, including Speech Pathology and Audiology area. Therefore, it is necessary to develop projects that assist the hearing impaired elderly in the process of fitting of hearing aids. Objective: To evaluate the DVD \"Knowing and Understanding about My Hearing Aid\" in the process of fitting of hearing aids. Methodology: The methodology was divided into two stages of development. In the first phase of the first stage, the mentioned educational materials on DVD was first evaluated by 22 audiologists and 25 elderly hearing aid users. In the second phase of the first stage, the suggestions made by the evaluators were analyzed for the restructuring of this DVD Volume 1. The second step was to verify the effectiveness of the new version of the DVD along with the elderly hearing impaired individuals new hearing aid users, with a control group of 14 individuals who received only hearing aid orientation and the experimental group, composed of 13 individuals who apart from hearing aid orientation, also received educational materials on DVD Volume 2. The effectiveness of the DVD version was measured by using the PHAST questionnaire, which was applied in groups E and F. Results: In the first stage, the evaluators suggested updating of models of BTE hearing aids, insertion time of cell activation and slower rate of speech and subtitles. The restructuring of the teaching material on DVD was accomplished through funding from FAPESP, which enabled the hiring of a producer to do the job. There was a restructuring of the script, filming and edits the video. The second stage, there was no statistically significant difference between the ease / difficulty of handling found in the experimental and control groups. The assessment made by the experimental group over how much the Volume 2 DVD helped in understanding the content on their devices, most of the sample reported that this \"very helpful\" in all points evaluated. The lowest rating was \"satisfactory\" to the points raised in the DVD, with no statistically significant difference when compared to former users of hearing aids. Discussion: The teaching material was evaluated, and backed its restructuring in studies aimed at preparing distance learning materials. All the difficulties encountered by the control and experimental groups corroborated the literature. The assessments made by the experimental group showed the high degree of satisfaction with the DVD Volume 2. Conclusions: The DVD \"Knowing and Understanding My Hearing Aid\" Volume 2 was evaluated, proving effective in helping the elderly new users of BTE hearing aids.

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Porcincula, Sidney. "Estudo da conformidade de formas de uso da telemedicina/telessaúde em relação aos modelos nacionais propostos." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/17/17157/tde-20072016-164001/.

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Apesar dos avanços tecnológicos voltados para o uso das Tecnologias da Informação e Comunicação em Saúde, vários aspectos normativos ainda estão sendo discutidos em âmbito nacional para o estabelecimento de uma legislação específica para a área de telemedicina. As normativas mais utilizadas como referência para definição do escopo de atuação profissional em telemedicina são: a RESOLUÇÃO CFM nº 1.643/2002, que define e disciplina a prestação de serviços através da Telemedicina e a RESOLUÇÃO CFM nº 2.107/2014, que define e normatiza a Telerradiologia e revoga a RESOLUÇÃO CFM nº 1890/09. Essa dissertação apresenta um estudo retrospectivo, quantitativo, descritivo, baseado em levantamento bibliográfico que tem como proposta verificar a conformidade das formas de uso da telemedicina e da telessaúde, nos contextos nacional e internacional, em relação ao modelo proposto para essa atividade pelo CFM, representado pelas resoluções 1.643/2002 e 2.107/2014. O levantamento bibliográfico foi feito no período de 2009 a 2015, nas bases de dados Scielo, PubMed e IEEE, com base nas palavras chaves videoconferencing, webconferencing, VTC, meeting, telemedicine e telehealth e suas combinações. Foram encontrados, incialmente, 2352 artigos que foram reduzidos para 572 após a leitura de seus resumos e, novamente reduzidos para 115, após a leitura parcial dos artigos. Os 115 artigos selecionados foram lidos na íntegra. Os resultados obtidos mostraram que o uso da telemedicina pode ampliar consideravelmente a área de atendimento especializado dos grandes centros médicos, o que deve ser incentivado, principalmente em países com menores recursos financeiros, ou com poucos especialistas, ou extremamente extensos, como no caso do Brasil
Despite technological advances aiming the best use of Information and Communication Technology in Healthcare, several normative aspects are still being discussed in national scope, in order to establish a specific legislation for telemedicine area. There are some specifically normative aspects for professional orientation in telemedicine as follows: CFM no. 1.643/2002 that define disciplines and services provided by telemedicine, and CFM no. 2.107/2014 that define and guide the teleradiology services. This work was a retrospective, quantitative and descriptive study based on bibliographic surveying, in order to verify the conformity of the use of telemedicine and telehealth in both national and international contexts, according to the CFM proposed model for this activity, represented by CFM resolutions no. 1.643/2002 and no. 2.107/2014. The bibliographic surveying between 2009 and 2015 used Scielo, PubMed, and IEEE databases, and the key words: videoconferencing, webconferencing, VTC, meeting, telemedicine, and telehealth plus their combinations. We found 2352 articles, reduced to 572 after reading their abstracts. One hundred and fifteen potentially relevant articles were selected after partial reading of the articles. After that, the 115 selected articles were fully read. The results showed that the use of telemedicine could considerably increase the area of specialized attending crew on important medical facilities, what should be encouraged mainly in countries with few or no financial resources, or the small number of specialists, or extensive areas such as Brazil

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Paixão, Mauricio Pedreira. "Modelo de educação a distância em hanseníase voltado para rede de detecção de casos e diagnóstico." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/5/5144/tde-17122008-192918/.

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INTRODUÇÃO: A hanseníase persiste como grave problema de saúde pública no Brasil, e não foi atingida até o momento a meta de eliminação determinada pela Organização Mundial da Saúde. As Equipes de Saúde da Família (ESFs) constituem uma ampla rede de profissionais que atuam na atenção primária. A educação a distância em hanseníase destas equipes representa uma estratégia atraente. Ao permitir a identificação precoce de casos, seguida de tratamento adequado, favorece a cura e reduz incapacidades e/ou seqüelas. MÉTODOS: Foi planejado o desenvolvimento de um Curso de Extensão Universitária, utilizando tecnologias interativas voltadas para a educação a distância dos profissionais da saúde. Contou-se com planejamento pedagógico específico. Durante este processo, previu-se que os centros de referências em hanseníase pudessem atuar junto a estes profissionais que trabalham em pontos isolados e com alta prevalência da doença. Foi planejada a elaboração do ambiente de teleducação para oferecimento do curso, incluindo a criação de um simulador de casos voltado para o reconhecimento da doença, além de outras informações julgadas essenciais por dermatologistas. Elaborou-se uma metodologia para avaliar a adequação do seu conteúdo. Baseado no questionário validado WEBMAC (Web Site Motivational Analysis Checklist), um instrumento padronizado foi desenvolvido para avaliar a satisfação deste curso a distância. RESULTADOS: Foi realizado um curso de hanseníase a distância, voltado para as Equipes de Saúde da Família (ESF) nas cidades de Manaus e Parintins, contando com fundamentação pedagógica baseada em conceitos construtivistas e da andragogia. As ferramentas do curso viabilizaram a interação entre os professores e os participantes. O Simulador de Casos (SC) demonstrou diferenças na capacidade de reconhecimento de casos em três grupos distintos, formados por: dermatologistas com experiência específica em hanseníase, dermatologistas sem experiência específica e alunos do quinto ano de medicina. Os dermatologistas com experiência específica obtiveram um melhor desempenho no SC. O seu conteúdo mostrou-se adequado na avaliação dos três grupos. Os participantes apresentaram retenção dos conceitos abordados no SC após um ano (avaliação tardia). Foi obtido elevado grau de satisfação com o curso por meio de instrumento padronizado. CONCLUSÃO: A estratégia educacional mostrou-se factível, e os resultados alcançados favorecem o desenvolvimento futuro de iniciativa em larga escala destinada à educação a distância em Hanseníase das ESFs e a abordagem de outros temas em saúde.
INTRODUCTION: Leprosy remains as a serious public health problem in Brazil, and it was not yet achieved the goal of eliminating leprosy determined by the World Health Organization. Family Health Teams (FHTs) form a wide network of professionals who work in primary care. Distance education in leprosy of these teams represents an attractive strategy. Since it could allow early case identification, followed by appropriate treatment, it maximizes cure and reduces disability and/or sequels. METHODS: It was planned to develop an Extension University Course, using interactive technologies directed to distance education of health professionals. It had specific educational plan. During this process, it was decided that leprosy reference centers could act with these professionals who work in isolated areas and with a high prevalence of the disease. It included the creation of a case simulator toward disease recognition, and extra information considered essential by dermatologists. A methodology to evaluate adequacy of its contents was created. Based on WEBMAC (Web Site Motivational Analysis Checklist) validated questionnaire, a standardized instrument was developed to assess the satisfaction of this course. RESULTS: It was realized a leprosy distance course, directed to FHTs from the cities of Manaus and Parintins, that included pedagogical fundamental based on constructivist and andragogic concepts. Course tools enabled interaction between teachers and participants. Case Simulator (CS) disclosed differences in the ability of recognition of cases into three distinct groups, formed by: dermatologists with specific experience in leprosy, dermatologists without specific experience and fifth year students of medicine. The dermatologists with specific experience obtained a better performance in the CS. Its content assessed by all three groups seemed to be appropriated. Participants showed retention of the concepts cited in the CS after a year (late evaluation). The course obtained high degree of satisfaction and it was demonstrated by standardized instrument. CONCLUSION: The course proved to be feasible, and results favor the development of future large-scale initiative focused on distance education in leprosy for FHTs and the approach to others health subjects.

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Ascencio, Ana Carolina Soares. "A Teleducação interativa na capacitação de profissionais em saúde auditiva." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/25/25143/tde-12062012-162945/.

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Introdução: A Telessaúde caracteriza-se pelo uso da tecnologia de informação e comunicação na área da saúde. Na Fonoaudiologia, o uso desta ferramenta por meio da Teleducação e Teleassistência se caracteriza como uma importante estratégia que leva a informação para alunos, profissionais, pacientes e comunidade em geral. Esse fator, aliado à grande extensão geográfica do Brasil e a distribuição heterogênea dos profissionais da saúde, vem ao encontro da necessidade de atendimento especializado para pacientes e descentralização do conhecimento para profissionais. Neste contexto, o uso da Teleducação emerge como uma proposta para minimizar as dificuldades encontradas pelo paciente, no processo de adaptação do aparelho de amplificação sonora individual (AASI), na qual muitos materiais educacionais são produzidos com o intuito de orientar e facilitar a adaptação do indivíduo deficiente auditivo, à sua nova realidade. Objetivo: Este projeto tem por objetivo elaborar um programa de capacitação por meio da Teleducação Interativa, sobre o aparelho de amplificação sonora individual, e analisar a eficácia do mesmo, quanto ao aprendizado e motivação dos profissionais. Resultados: A primeira etapa compreendeu a elaboração do programa de capacitação, na qual foi desenvolvido um cybertutor sobre o tema AASI e as ferramentas fórum de discussão e web conferência, com o intuito de complementar o aprendizado. Na segunda etapa, referente à análise do programa, verificou-se que não houve significância estatística no aspecto relacionado ao aprendizado do conteúdo, na avaliação pré e pós teste. Em relação à motivação dos profissionais, o estudo obteve resultado positivo, sendo avaliado como curso impressionante. Discussão: O programa de capacitação foi desenvolvido, respaldado em estudos voltados para elaboração de materiais didáticos à distância. No que se referem aos resultados da avaliação, todas as dificuldades encontradas neste aspecto corroboraram com a literatura. Conclusão: A elaboração do Programa de Capacitação por meio da Teleducação Interativa sobre o tema aparelho de amplificação sonora individual (AASI) foi realizada satisfatoriamente, alcançando um índice de motivação em relação à participação altamente positivo, porém os resultados da comparação da avaliação da situação problema pré e pós teste não foram estatisticamente significantes.
Introduction: Telehealth is characterized by the use of information technology and communication in healthcare. In audiology, the use of this tool through Telecare and Tele-education is characterized as an important strategy that leads the information for students, professionals, patients and the general community. This factor, combined with the large geographical extent of Brazil and the heterogeneous distribution of health professionals, meets the need of specialized care for patients and decentralization of knowledge for professionals. In this context, the use of Tele-education has emerged as a proposal to minimize the difficulties encountered by the patient in the process of adaptation of a hearing aids (HA), in which many educational materials are produced in order to guide and facilitate the adaptation HA to their new reality. Objective: This project aims to develop a training program through the Interactive Tele-education on the individual sound amplification devices, and analyze the effectiveness of the same as learning and motivation. Results: The first stage of the preparation of the training program, which was developed on the theme Cybertutor hearing aids and tools discussion forum and web conferencing in order to supplement learning. In the second stage, regarding the analysis of the program, it was found that there was no statistical significance in the learning aspect of the content, in the pre and post test. Regarding the motivation of staff, the study was positive, which was assessed as \"impressive progress\". Discussion: The training program was developed, backed up by studies aimed at developing distance learning materials. In that refer to results of the evaluation, all difficulties found in this aspect corroborated with the literature. Conclusion: The development of the Training Program through the Interactive Tele-education on the subject of HA was performed satisfactorily, reaching a level of motivation in relation to participation highly positive, but the comparison results of the evaluation of the problem situation pre and post-test were not statistically significant.

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Sundberg, Axel, and Gabriel Tiby. "Läka på distans? : perspektiv på egenvård inom telemedicin." Thesis, Sophiahemmet Högskola, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-4047.

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Bakgrund I takt med samhällets digitalisering har telemedicin, vård på distans, kommit att spela en allt mer framträdande roll inom hälso-och sjukvården. Inom ramen för det digitala kan patienter numera uppsöka samt erhålla vård från sina egna hem. Den ökade tillgängligheten som telemedicinen för med sig kan fostra en mer aktiv patientroll inom vilken egenvården är av särskild betydelse. Lärdomar kan tas från patienter som använt sig av telemedicinska tjänster och genom att utforska deras upplevelser kan möjligheter och hinder identifieras. SyfteSyftet var att beskriva patienters upplevelser av egenvård vid användning av telemedicin. Metod Denna studie är utförd som en litteraturöversikt och baserade sig på 16 relevanta vetenskapliga artiklar med en kvalitativ ansats. Artiklarna har med olika sökordskombinationer valts ut från databaserna PubMed och CINAHL. De valda artiklarna kvalitetsgranskades enligt Sophiahemmet högskolas bedömningsinstrument varpå en integrerad innehållsanalys utfördes. Resultatartiklarna delades in i tre kategorier med sex tillhörande underkategorier. Resultat Resultatet delades in i tre kategorier; egenvårdsbehov, egenvårdskapacitet samt egenvårdsbrist. Den första kategorin handlar om patienters upplevelser av autonomi och tillgänglighet. Den andra kategorin behandlar patienters nya roll samt upplevelser av delaktighet. Den tredje kategorin behandlar aspekterna relation och partnerskap. Slutsats Denna studie belyser hur patienter ser både för- och nackdelar med telemedicin. Patienter upplever att telemedicin i mångt och mycket har kapacitet att förstärka deras möjligheter till egenvård och delaktighet men att det finns brister. Telemedicinen är till för alla men förutsätter ett visst krav på tekniskt kunnande samt en vilja till förändring vilket riskerar att utelämna patienter som inte vill eller har möjlighet. Därmed bör lärdom tas från patienternas erfarenheter för att på så sätt använda telemedicinen som ett verktyg för att bidra till en god och jämlik hälso- och sjukvård där alla inkluderas.

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Ishioka, Priscila [UNIFESP]. "Teledermatoscopia das lesões cutâneas pigmentadas." Universidade Federal de São Paulo (UNIFESP), 2009. http://repositorio.unifesp.br/handle/11600/10105.

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Objetivos: Avaliar a concordância no diagnóstico das lesões cutâneas pigmentadas por meio do exame dermatoscópico presencial e a distância. Analisar a concordância diagnóstica da teledermatoscopia e do exame dermatoscópico presencial em relação ao resultado anatomopatológico. Verificar a acurácia, a sensibilidade e a especificidade da teledermatoscopia na detecção das lesões pigmentadas malignas. Métodos: Sessenta e quatro lesões cutâneas pigmentadas foram submetidas a exame clínico e dermatoscópico realizado presencialmente por dois examinadores com experiência em dermatoscopia, durante o ano de 2005, no ambulatório de dermatoscopia do Departamento de Dermatologia da Universidade Federal de São Paulo (UNIFESP). Após dois anos, imagens digitais clínicas e dermatoscópicas destes casos foram reexaminadas pelos mesmos especialistas por meio da transmissão de imagens e de dados clínicos via web. Resultados: Observou-se boa concordância diagnóstica entre o exame presencial e a teledermatoscopia com valor de Kappa de 0,698 (IC a 95% - [0,575; 0,821]). Verificou-se também boa concordância entre o exame presencial e a teledermatoscopia com o resultado anatomopatológico (padrão ouro) com valores de Kappa de 0,728 (IC a 95% - [0,608; 0,848]) e 0,656 (IC a 95% - [0,526; 0,785]), respectivamente. Constatou-se 84% de acurácia, 93% de sensibilidade e 78% de especificidade na detecção das lesões pigmentadas malignas no exame dermatoscópico a distância. Dois casos falsos negativos foram observados pela teledermatoscopia. Não houve diferença estatisticamente significante entre a sensibilidade, a especificidade e a acurácia das duas modalidades diagnósticas. Conclusões: O exame dermatoscópico a distância pela transmissão de imagens digitais e de dados clínicos proporcionou acurácia diagnóstica, sensibilidade e especificidade comparáveis ao exame convencional. A teledermatoscopia mostrou ser método eficaz e confiável na detecção das lesões malignas constituindo ferramenta importante na triagem das lesões pigmentadas. A boa concordância diagnóstica entre a avaliação via web e o exame presencial destaca a aplicabilidade da teledermatoscopia como instrumento de assistência especializada em regiões de difícil acesso ou carentes no setor de saúde.
Objectives: To evaluate agreement in diagnosis of pigmented skin lesions through presential or remote dermoscopic examination. To analyze diagnosis agreement of teledermoscopy and presential dermoscopic examination regarding pathological findings. To verify accuracy, sensibility and specificity of teledermoscopy in detection of malignant pigmented lesions. Methods: A total of 64 pigmented skin lesions were submitted to clinical and dermoscopic examinations performed presentially by two examiners experienced in dermoscopy, at the Dermoscopy Outpatient’s Clinic, Department of Dermatology, Universidade Federal de São Paulo (UNIFESP), in 2005. Two years later, the digital clinical and dermoscopic images of these cases were re-examined by the same specialists through transmission of images and clinical data via web. Agreement between presential diagnosis and telediagnosis was assessed by the Kappa (κ) statistic calculation and its respective 95% confidence interval (95% CI). Through this calculation, the agreement between presential presumptive diagnoses and telediagnoses with pathological findings was analyzed. Sensitivity, specificity and accuracy of two diagnostic modalities were obtained using the pathological examination as the gold standard. The respective 95% confidence interval (95% CI) was calculated for each diagnostic measurement. Results: Good diagnostic agreement was observed between presential examination and teledermoscopy, with a Kappa value of 0.698 (95% CI - [0.575; 0.821]). Good agreement was also found between conventional examination and teledermoscopy, and the pathological findings (gold standard) had Kappa values of 0.728 (95% CI - [0.608; 0.848]) and 0.656 (95% CI - [0.526; 0.785]), respectively. Accuracy of 84%, sensitivity of 93% and specificity of 78% were observed in detecting malignant pigmented lesions by remote dermoscopic examination. Two false negative cases were observed through teledermoscopy. There was no statistically significant difference in sensitivity, specificity and accuracy of both diagnostic methods. Conclusions: Remote dermoscopic examination by means of digital image transmission and of clinical data provided diagnostic accuracy, sensitivity and specificity comparable to conventional examination. Teledermoscopy proved to be an efficient and reliable method to detect malignant lesions, representing an important tool to screen pigmented lesions. The good diagnostic agreement between assessment via web and conventional examination highlights the applicability of teledermoscopy as a specialized assistance tool in regions that are difficult to reach or lack health resources.
TEDE
BV UNIFESP: Teses e dissertações

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Pinheiro, Fernanda Machado. "Acompanhamento por telefone no pós-alta hospitalar de idosos hipertensos: estudo piloto randomizado." Universidade Federal Fluminense, 2015. https://app.uff.br/riuff/handle/1/2356.

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Mestrado Acadêmico em Ciências do Cuidado em Saúde
Estudo piloto randomizado que teve como objetivos analisar a associação da intervenção acompanhamento por telefone com a adesão terapêutica de idosos com hipertensão arterial sistêmica no pós-alta e o evento readmissão hospitalar. Os participantes foram idosos com idade de 60 anos ou mais, internados nas enfermarias de clínica médica de um hospital universitário mediante os seguintes critérios de inclusão: ter diagnóstico médico de hipertensão arterial e aparelho telefônico; e a exclusão: capacidade funcional totalmente dependente de acordo com o Index de Katz; Mini Exame do Estado Mental com escore < a 24; transferência de setor. Para descontinuidade: participantes que não atenderam 75% das chamadas telefônicas; óbito no intra-hospital. Para alocação aleatória simples foi utilizada uma tabela de randomização aleatória sem reposição do software Bioestat 4.0. O grupo controle foi composto por 17 participantes e o grupo experimento por 12 participantes. Após a alta hospitalar os pacientes do grupo experimento foram acompanhados por telefone durante 3 meses e o grupo controle recebeu apenas 1 ligação após 3 meses da alta hospitalar. Para a análise estatística dos dados utilizou-se o software Statistical Package for the Social Scienses (SPSS) 18.0. Os dados categóricos foram expressos em frequência e percentual e os dados numéricos em medidas de tendência central: média e mediana; e de dispersão: DP; mínimo e máximo; coeficiente de variação. A média de idade 73,6 anos (8,9) para o grupo controle e 69,2 anos (7,0) para o experimento. a média de dias de internação foi de 13,5 dias para o grupo controle e 21 dias para o grupo experimento. As intervenções que mais se destacaram foram: aconselhamento, escutar ativamente, apoio emocional, suporte à família e encaminhamento. Os participantes do grupo controle levaram em média 34,2 dias para retornar ao serviço de saúde após a alta, e o grupo experimento em média 46,9 dias. Ocorreram 5 óbitos de idosos, sendo três no grupo controle e dois no grupo experimento e 3 reinternações para ambos os grupos. Os óbitos registrados foram por doença cardiovascular (arritmia) e doença neurológica no grupo controle, doença cardiovascular e doença geniturinária no grupo experimento. Não houve registro de demanda espontânea, no entanto foi relatado satisfação durante o acompanhamento. Conclui-se que o acompanhamento pós-alta é uma tecnologia viável de ser empregada na atenção ao idoso hipertenso por favorecer a proximidade e o suporte necessários que podem propiciar mais segurança na adesão e o seguimento do tratamento com reflexos na prevenção e identificação de complicações que levam ao evento reinternação hospitalar.

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Kunert-Keil, Christiane, Dominik Haim, Karol Kozak, Ines Zeidler-Rentzsch, Bernhard Weiland, Olaf Müller, Thomas Treichel, and Günter Lauer. "3D-volldigitalisierte Behandlungsplanung bei Lippen-Kiefer-Gaumenspalten." Thelem Universitätsverlag & Buchhandlung GmbH & Co. KG, 2019. https://tud.qucosa.de/id/qucosa%3A36922.

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Die Idealvorstellung eines vollständig digitalisierten Behandlungsalltags rückt mit fortschreitender technologischer und informationeller Entwicklung stetig näher an die Realität. Zu Beginn bestand lediglich die Möglichkeit einer elektronischen Patientenakte, hinzu kamen vielfältige Möglichkeiten der digitalen Bildgebung und wurden schließlich um das Ziel eines vollständigen digitalen Workflows ergänzt. Die Planung der interdisziplinären kieferorthopädischen / kieferchirurgischen Versorgung von Patienten mit Lippen-Kiefer-Gaumen-Spalten (LKGS) wird momentan noch hauptsächlich analog durchgeführt. Eine volldigitalisierte Behandlungsplanung und –freigabe unter intersektoraler Einbeziehung aller beteiligten Behandler findet nicht statt. Neu entwickelte, digitale kieferorthopädische und –chirurgische Produkte, welche bis vor ein paar Jahren noch nicht denkbar waren, unterstützen den digitalen Workflow maßgeblich. 3D-Scanner und 3D-Fotoaufnahmen erstellen digitale Modelle, deren Daten zur Integration in den digitalen Workflow durch Softwareprozesse verarbeitet werden müssen. Um einen einfachen und strukturierten Zugriff auf die gesamten 3D Daten zu gewährleisten, ist die Idee entstanden, die anfallenden Daten und Unterlagen zu digitalisieren und in einer für diesen Zweck entwickelten Datenbank zu speichern und zu bearbeiten. Die konsequente Verwendung von digitalen 3D-Analysen und der Verzicht auf die aufwändige Erstellung der Diagnostik- und Therapieplanung aus einer Kombination von Gipsmodellen und 2D-Daten (z.B. Röntgenbilder) führen zu einer fundamentalen und richtungsweisenden Veränderung des Behandlungsplanungsprozesses. Räumlich und monetär aufwendige Bearbeitungsprozesse werden eingespart und Behandlungspläne können rascher erstellt werden, da sich alle notwendigen Unterlagen gebündelt in einem System wiederfinden. Weiterhin wird die Strahlenbelastung der Patienten wesentlich verringert, da eine Doppeldiagnostik durch mehrmaliges Anfertigen von Röntgenaufnahmen, DVTs und CTs in verschiedenen Abteilungen vermieden wird. Die Kommunikation, der Austausch und die konsiliarische Zusammenarbeit zwischen den Behandlern erfolgt unter Verwendung der europaweit ersten offenen, überregionalen telemedizinischen Plattform zur Verbesserung der medizinischen Versorgung – CCS TELEHEALTH OSTSACHSEN (THOS). [... aus der Einleitung]

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Barros, Júnior Euclides de Moraes. "Telemedicina teleradiologia." Florianópolis, SC, 2000. http://repositorio.ufsc.br/xmlui/handle/123456789/79085.

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Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico.
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O objetivo deste trabalho é mostrar o sistema de Sala de Laudos Virtual, como tema de dissertação do curso de Pós-Graduação da Universidade Federal de Santa Catarina. Este sistema permite equipes médicas radiológicas acessarem banco de imagens em conformidade ao padrão DICOM 3.0 (Digital Image Communications in Medicine), provenientes de equipamentos radiologicos, disponibilizar estas imagens com outros médicos localizados geograficamente distantes, utilizando a tecnologia Internet existente para a elaboração conjunta do laudo e diagnóstico dos pacientes, através de um editor de laudos, ferramentas de manipulação de imagens compartilhadas entre os participantes da Sala de Laudos Virtual e um canal de áudio conferência. Este ambiente permite um melhor diagnóstico em casos difíceis, utilizando-se de opiniões de outros especialistas, repercutindo em melhores tratamentos para os pacientes, os médicos não precisam estar fisicamente presentes nas salas de laudos de clinicas e hospitais e a não necessidade de impressão de chapas radiológicas, ocasionado com isto reduções de custos.

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Sutter, Berthel. "Instruction at heart : activity-theoretical studies of learning and development in coronary clinical work /." Karlskrona : Blekinge Institute of Technology, 2001. http://www.bth.se/fou/forskinfo.nsf/01f1d3898cbbd490c12568160037fb62/0409ef09b02780cfc1256c3300435117!OpenDocument.

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Bergström, Stina. "Telemedicin i Västerbottens läns landsting : Diffusion och kartläggning av telemedicin ur ett geografiskt perspektiv." Thesis, Umeå universitet, Institutionen för ekologi, miljö och geovetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-95981.

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Telemedicine is the use of information and communication technology to provide clinical health care at a distance. This approach is usually adopted to bridge the distance in rural settings, but it is also a method to meet demographical and economical challenges. Västerbotten, a sparsely populated county with an ageing population, is in leading edge when it comes to telemedicine. The purpose of this report was to examine the diffusion and the inventory of telemedicine in the county council of Västerbotten from a geographical perspective. To gain a deeper understanding of diffusion and inventory of telemedicine, my purpose was also to examine these processes from an international and national perspective. Telemedicine and diffusion as concepts, and how these have been portrayed in the literature were studied, as well as the driving forces behind, and the barriers to further diffusion of telemedicine. The main focus in the report was telemedicine in the county council of Västerbotten and their ongoing inventory of telemedicine. The background of the inventory, how it is being performed and what the results have been up to this date were investigated. All these aspects were performed through interviews. An important factor to successful implementation of telemedicine, is the use of comprehensive and systematic performed evaluations of telemedicine activities. The inventory performed by the county council of Västerbotten is an important contribution to the lack of evidence in this area. Although, a major barrier to successful implementation and further diffusion of telemedicine, appears to be attitudes among health care staff.

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