Online, House Call, and Other Services

2014 ◽  
pp. 168-199
Keyword(s):  
Real Time ◽  
Digital Media ◽  
Nurse Practitioners ◽  
Healthcare Services ◽  
Care Physician ◽  
X Rays ◽  
Emergency Rooms ◽  
Online Interactions ◽  
House Call ◽  
Store And Forward

This chapter focuses on new healthcare services provided online, in the patient home, and elsewhere. Under the umbrella of telehealth, there are three key modes of delivery. First, real time (synchronous) delivery requires a live telecommunication connection and uses phones, video conferencing, and chat sessions. Second, “store & forward” (asynchronous) delivery captures digital media and transmits to it to providers via images, video, audio, x-rays, etc. Third, remote monitoring (synchronous or not) is a combination of real-time and store and forward and it uses connected devices. The author highlights the example of several online care companies such as Hello Health, virtuwell, Zipnosis, and American Well. House call services by nurse practitioners are on the rise again. The author focuses on the example of WhiteGlove, a service that offers access to nurse practitioner care at home or at the office seven days a week. They conclude that many patient visits to the hospital emergency rooms and to primary care physician offices are unnecessary and can be taken care of in a much cheaper and more convenient way through online interactions and house visits.

scholarly journals Big data actionable intelligence architecture

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Tian J. Ma ◽  
Rudy J. Garcia ◽  
Forest Danford ◽  
Laura Patrizi ◽  
Jennifer Galasso ◽  
...  
Keyword(s):  
Big Data ◽  
Real Time ◽  
Digital Media ◽  
Decision Makers ◽  
Time Data ◽  
Human In The Loop ◽  
Course Of Action ◽  
Insufficient Time ◽  
Data Source ◽  
Different Sources

AbstractThe amount of data produced by sensors, social and digital media, and Internet of Things (IoTs) are rapidly increasing each day. Decision makers often need to sift through a sea of Big Data to utilize information from a variety of sources in order to determine a course of action. This can be a very difficult and time-consuming task. For each data source encountered, the information can be redundant, conflicting, and/or incomplete. For near-real-time application, there is insufficient time for a human to interpret all the information from different sources. In this project, we have developed a near-real-time, data-agnostic, software architecture that is capable of using several disparate sources to autonomously generate Actionable Intelligence with a human in the loop. We demonstrated our solution through a traffic prediction exemplar problem.

scholarly journals The Use of Synchrotron X-rays To Observe Copper Corrosion in Real Time

2012 ◽  
Vol 84 (11) ◽  
pp. 4866-4872 ◽  
Author(s):  
Mark Dowsett ◽  
Annemie Adriaens ◽  
Chris Martin ◽  
L. Bouchenoire
Keyword(s):  
Real Time ◽  
X Rays ◽  
Copper Corrosion

scholarly journals Real-Time Heart Pulse Monitoring Technique Using Wireless Sensor Network and Mobile Application

2018 ◽  
Vol 8 (6) ◽  
pp. 5118 ◽  
Author(s):  
Nabeel Salih Ali ◽  
Zaid Abdi Alkaream Alyasseri ◽  
Abdulhussein Abdulmohson
Keyword(s):  
Real Time ◽  
Mobile Application ◽  
Electronic Circuit ◽  
Healthcare Services ◽  
Wireless Sensor ◽  
Sensor Technology ◽  
Medical Monitoring ◽  
Monitoring Technique ◽  
Arduino Microcontroller ◽  
User Friendly

Wireless Sensor Networks (WSNs) for healthcare have emerged in the recent years. Wireless technology has been developed and used widely for different medical fields. This technology provides healthcare services for patients, especially who suffer from chronic diseases. Services such as catering continuous medical monitoring and get rid of disturbance caused by the sensor of instruments. Sensors are connected to a patient by wires and become bed-bound that less from the mobility of the patient. In this paper, proposed a real-time heart pulse monitoring system via conducted an electronic circuit architecture to measure Heart Pulse (HP) for patients and display heart pulse measuring via smartphone and computer over the network in real-time settings. In HP measuring application standpoint, using sensor technology to observe heart pulse by bringing the fingerprint to the sensor via used Arduino microcontroller with Ethernet shield to connect heart pulse circuit to the internet and send results to the web server and receive it anywhere. The proposed system provided the usability by the user (user-friendly) not only by the specialist. Also, it offered speed andresults accuracy, the highest availability with the user on an ongoing basis, and few cost.

scholarly journals A Retrospective Analysis of Provider-to-Patient Secure Messages: How Much Are They Increasing, Who Is Doing the Work, and Is the Work Happening After Hours? (Preprint)

2019 ◽  
Author(s):  
Frederick North ◽  
Kristine E Luhman ◽  
Eric A Mallmann ◽  
Toby J Mallmann ◽  
Sidna M Tulledge-Scheitel ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Care Physician ◽  
Work Hours ◽  
Patient Portal ◽  
Secure Messaging ◽  
After Hours ◽  
Over Time

BACKGROUND Patient portal registration and the use of secure messaging are increasing. However, little is known about how the work of responding to and initiating patient messages is distributed among care team members and how these messages may affect work after hours. OBJECTIVE This study aimed to examine the growth of secure messages and determine how the work of provider responses to patient-initiated secure messages and provider-initiated secure messages is distributed across care teams and across work and after-work hours. METHODS We collected secure messages sent from providers from January 1, 2013, to March 15, 2018, at Mayo Clinic, Rochester, Minnesota, both in response to patient secure messages and provider-initiated secure messages. We examined counts of messages over time, how the work of responding to messages and initiating messages was distributed among health care workers, messages sent per provider, messages per unique patient, and when the work was completed (proportion of messages sent after standard work hours). RESULTS Portal registration for patients having clinic visits increased from 33% to 62%, and increasingly more patients and providers were engaged in messaging. Provider message responses to individual patients increased significantly in both primary care and specialty practices. Message responses per specialty physician provider increased from 15 responses per provider per year to 53 responses per provider per year from 2013 to 2018, resulting in a 253% increase. Primary care physician message responses increased from 153 per provider per year to 322 from 2013 to 2018, resulting in a 110% increase. Physicians, nurse practitioners, physician assistants, and registered nurses, all contributed to the substantial increases in the number of messages sent. CONCLUSIONS Provider-sent secure messages at a large health care institution have increased substantially since implementation of secure messaging between patients and providers. The effort of responding to and initiating messages to patients was distributed across multiple provider categories. The percentage of message responses occurring after hours showed little substantial change over time compared with the overall increase in message volume.

scholarly journals Teledermatology in the Saudi Arabian Healthcare System: Utilization and Challenges

2021 ◽  
pp. 1-5
Author(s):  
Alhanouf A. Bin Dakhil ◽  
Saad Altalhab
Keyword(s):  
Medical Education ◽  
Saudi Arabia ◽  
Inpatient Care ◽  
Data Access ◽  
Visual Assessment ◽  
Healthcare Services ◽  
Wait Times ◽  
Privacy Concerns ◽  
System Utilization ◽  
Store And Forward

<b><i>Background:</i></b> In recent years, telemedicine has led to a dramatic shift in healthcare service delivery, mainly due to the ease with which telemedicine can be integrated into a multitude of specialties and its flexibility as a means of providing care. Over the last 2 decades, technological advancements have made telemedicine integral to healthcare in many countries. In particular, dermatology was benefited from telemedicine as a new tool, thanks to the visual character that pervades this practice. Teledermatology is the interactive practice of remote dermatological assessment, involving live contact with patients (“live interactive”) and data access and retrieval (“store-and-forward”). This review discusses the role of this new discipline in medical education, inpatient care, and primary care through the analysis of several studies addressing this topic. Also examined are the status and limitations of teledermatology in Saudi Arabia and some proposed solutions. <b><i>Summary:</i></b> Visual assessment of dermatological conditions is common practice among dermatologists. However, due to the scarcity of specialists in some areas, wait times have been a hindrance for patients requiring an assessment. Teledermatology improves access by reducing wait times, speeding up the referral process, and streamlining assessments. Furthermore, teledermatology effectively serves as a form of triage, particularly for cases of suspected cutaneous malignancy that typically require the shortest referral time. Earlier diagnoses, more effective management of chronic skin disease, and inpatient care are all additional benefits offered by the teledermatology practice. The use of teledermatology is now widespread, with roles extending beyond patient care to medical teaching and training in residency programs. This perhaps reflects physicians’ highly positive perceptions regarding teledermatology; however, patient perception in Saudi Arabia is still lagging behind the global standard, possibly due to privacy concerns. <b><i>Key Message:</i></b> Teledermatology can be reliably utilized to advance healthcare services and medical education. Improving patient awareness and perception of this emerging discipline is crucial; to that end, the practice must address privacy concerns. Patient uploads of photographs and videos should be stored on an end-to-end encrypted platform to provide optimal service and encourage patients’ participation. Ultimately, physicians should be well acquainted with the medical, ethical, and technical aspects of teledermatology.

Study of Real-Time Cardiac Monitoring System

2018 ◽  
pp. 188-198 ◽  
Author(s):  
Uma Arun ◽  
Natarajan Sriraam
Keyword(s):  
Real Time ◽  
Monitoring System ◽  
Cost Effective ◽  
Healthcare Services ◽  
Cardiac Monitoring ◽  
Diagnostic Quality ◽  
Ecg Signals ◽  
Comprehensive Survey ◽  
Primary Advantage ◽  
Insight Into

Today's healthcare technology provides promising solutions to cater to the needs of patients. The development of wearable physiological monitoring system has reached home-centric patients by ensuring faster healthcare services. The primary advantage of this system is activation of alarms to alert the specialist in a nearby hospital to attend to any sort of emergency. Specifically, cardiac-related problems need special attention when a 24-hour Holter monitors ECG signals and identifies the level of abnormalities under various circumstances. Although several brands of Holters exist in market, there is a huge demand for digitized Holter recorders. These recorders can simultaneously analyse cardiac signals in real time mode and store the data and reuse them for next 24 hours. As home-centric based wearable cardiac monitoring system gains much attention recently, there is a need to design and develop a cardiac monitoring system by establishing a trade-off between the required clinical diagnostic quality and cost. This research study highlights a comprehensive survey of various cardiac monitoring systems under wire, wireless and wearable modes. This provides an insight into the need of the hour in bringing a cost-effective wearable system. The study provides an insight of the technological aspects of the existing cardiac monitoring system and suggests a viable design suitable for developing countries.

An IoMT-based geriatric care management system for achieving smart health in nursing homes

2019 ◽  
Vol 119 (8) ◽  
pp. 1819-1840 ◽  
Author(s):  
Valerie Tang ◽  
K.L. Choy ◽  
G.T.S. Ho ◽  
H.Y. Lam ◽  
Y.P. Tsang
Keyword(s):  
Nursing Homes ◽  
Real Time ◽  
Health Monitoring ◽  
Management System ◽  
Care Management ◽  
Healthcare Services ◽  
Geriatric Care ◽  
Care Plan ◽  
Biometric Data ◽  
Content Type

Purpose The purpose of this paper is to develop an Internet of medical things (IoMT)-based geriatric care management system (I-GCMS), integrating IoMT and case-based reasoning (CBR) in order to deal with the global concerns of the increasing demand for elderly care service in nursing homes. Design/methodology/approach The I-GCMS is developed under the IoMT environment to collect real-time biometric data for total health monitoring. When the health of an elderly deteriorates, the CBR is used to revise and generate the customized care plan, and hence support and improve the geriatric care management (GCM) service in nursing homes. Findings A case study is conducted in a nursing home in Taiwan to evaluate the performance of the I-GCMS. Under the IoMT environment, the time saving in executing total health monitoring helps improve the daily operation effectiveness and efficiency. In addition, the proposed system helps leverage a proactive approach in modifying the content of a care plan in response to the change of health status of elderly. Originality/value Considering the needs for demanding and accurate healthcare services, this is the first time that IoMT and CBR technologies have been integrated in the field of GCM. This paper illustrates how to seamlessly connect various sensors to capture real-time biometric data to the I-GCMS platform for responsively supporting decision making in the care plan modification processes. With the aid of I-GCMS, the efficiency in executing the daily routine processes and the quality of healthcare services can be improved.

scholarly journals Emergency department resource optimisation for improved performance: a review

2019 ◽  
Vol 15 (S1) ◽  
pp. 253-266 ◽  
Author(s):  
Kazi Badrul Ahsan ◽  
M. R. Alam ◽  
Doug Gordon Morel ◽  
M. A. Karim
Keyword(s):  
Nurse Practitioners ◽  
Patient Flow ◽  
Demand Management ◽  
Discrete Event ◽  
Healthcare Services ◽  
Models Of Care ◽  
Analytical Models ◽  
Fast Tracking ◽  
Advantages And Disadvantages ◽  
Modelling Techniques

AbstractEmergency departments (EDs) have been becoming increasingly congested due to the combined impacts of growing demand, access block and increased clinical capability of the EDs. This congestion has known to have adverse impacts on the performance of the healthcare services. Attempts to overcome with this challenge have focussed largely on the demand management and the application of system wide process targets such as the “four-hour rule” intended to deal with access blocks. In addition, EDs have introduced various strategies such as “fast tracking”, “enhanced triage” and new models of care such as introducing nurse practitioners aimed at improving throughput. However, most of these practices require additional resources. Some researchers attempted to optimise the resources using various optimisation models to ensure best utilisation of resources to improve patient flow. However, not all modelling approaches are suitable for all situations and there is no critical review of optimisation models used in hospital EDs. The aim of this article is to review various analytical models utilised to optimise ED resources for improved patient flow and highlight benefits and limitations of these models. A range of modelling techniques including agent-based modelling and simulation, discrete-event simulation, queuing models, simulation optimisation and mathematical modelling have been reviewed. The analysis revealed that every modelling approach and optimisation technique has some advantages and disadvantages and their application is also guided by the objectives. The complexity, interrelationships and variability of ED-related variables make the application of standard modelling techniques difficult. However, these models can be used to identify sources of flow obstruction and to identify areas where investments in additional resources are likely to have most benefit.

scholarly journals Validation of use of billing codes for identifying telemedicine encounters in administrative data

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Deepika Yeramosu ◽  
Florence Kwok ◽  
Jeremy M. Kahn ◽  
Kristin N. Ray
Keyword(s):  
Administrative Data ◽  
Care Delivery ◽  
Healthcare Services ◽  
Data Set ◽  
Face To Face ◽  
Weighted Analysis ◽  
Ongoing Work ◽  
Services Evaluation ◽  
Store And Forward

Abstract Background Telemedicine is the use of telecommunication technology to remotely provide healthcare services. Evaluation of telemedicine use often relies on administrative data, but the validity of identifying telemedicine encounters in administrative data is not known. The objective of this study was to assess the accuracy of billing codes for identifying telemedicine use. Methods In this retrospective study of encounters within a large integrated health system from January 2016 to December 2017, we examined the accuracy of billing codes for identifying live-interactive and store-and-forward telemedicine encounters compared to manual chart review. To further examine external validity, we applied these codes and assessed patient and visit characteristics for identified live-interactive telemedicine encounters and store-and-forward telemedicine encounters in a second data set. Results In manual review of 390 encounters, 75 encounters were live-interactive telemedicine and 158 were store-and-forward telemedicine. In weighted analysis, the presence of the GT modifier in the absence of the GQ modifier or CPT code 99444 yielded 100% sensitivity and 99.99% specificity for identification of live-interactive telemedicine encounters. The presence of either the GQ modifier or the CPT code 99444 had 100% sensitivity and 100% specificity for identification of store-and-forward telemedicine encounters. Applying these algorithms to a second data set (n = 5,917,555) identified telemedicine encounters with expected patient and visit characteristics. Conclusions These findings provide support for use of CPT codes to perform telemedicine research in administrative data, aiding ongoing work to understand the role of non-face-to-face care in optimizing health care delivery.

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