This study demonstrated that diabetic teaching using via video conferencing based telemedicine was as effective as in-person teaching in improving control and patient satisfaction.
The advantage that diabetic teaching via telemedicine offers over the traditional face to face encounter, is the ability to deploy essential diabetic teaching across a wider region, thus solving the problem of access that many patients face.
Ideally, I envision that a patient should be able to visit their physician , and then from the same office visit, access the diabetic trainer via the video conferencing. Toward the end of the session, the patient and the remotely located diabetic educator would do a recap with the physician in order to insure the everyone is on the same page. This would be a way to decrease the level of fragmentation that can exist in diabetic care when multiple providers are involved.
The results of the study are listed below:
RESULTS—Patient satisfaction was high in the telemedicine group. Problem Areas in Diabetes scale scores improved significantly with diabetes education (adjusted P <>1c improved from 8.6 ± 1.8% at baseline to 7.8 ± 1.5% immediately after education and 7.8 ± 1.8% 3 months after the third educational visit (unadjusted P <>P = 0.089 adjusted for BMI and age), with similar changes observed in the telemedicine and in-person groups.
Thursday, January 28, 2010
Wednesday, January 13, 2010
Friday, January 8, 2010
Thursday, December 10, 2009
Telemedicine for Orthopedics
Orthopedics may be an opportunity for telemedicine. It may be especially useful in the correctional center setting where travel time for an orthopedic physician mY be an inefficient use of a valuable resource. See the abstract below:
Outpatient Orthopedics and the Impact of Telemedicine Upon Costs and Patient Care
Richard M. Garden, MD
Utah Department of Corrections, P.O. Box 250, Draper, UT 84020. Phone: (801) 576-7100.rgarden@utah.gov
In an effort to investigate and evaluate a start-up telemedicine program, the first two years of conducting orthopedic clinics via telemedicine were analyzed. These years were compared to the last full year during which all such clinics were conducted off site. The numbers of off-site visits, surgeries, total visits, grievances (patient complaints), and costs associated with on-site telemedicine (telecasts) were compared for years 1997, 1999, and 2000. A major reduction in the need for off-site visits, a small change in costs, a small increase in total utilization, a decrease in orthopedic-related grievances, and minimal changes in the number of surgeries were found. It was concluded that telemedicine is a fruitful endeavor and also offers a few less tangible benefits and lessons learned.
Journal of Correctional Health Care, Vol. 9, No. 1, 53-61 (2002)
DOI: 10.1177/107834580200900106
Outpatient Orthopedics and the Impact of Telemedicine Upon Costs and Patient Care
Richard M. Garden, MD
Utah Department of Corrections, P.O. Box 250, Draper, UT 84020. Phone: (801) 576-7100.rgarden@utah.gov
In an effort to investigate and evaluate a start-up telemedicine program, the first two years of conducting orthopedic clinics via telemedicine were analyzed. These years were compared to the last full year during which all such clinics were conducted off site. The numbers of off-site visits, surgeries, total visits, grievances (patient complaints), and costs associated with on-site telemedicine (telecasts) were compared for years 1997, 1999, and 2000. A major reduction in the need for off-site visits, a small change in costs, a small increase in total utilization, a decrease in orthopedic-related grievances, and minimal changes in the number of surgeries were found. It was concluded that telemedicine is a fruitful endeavor and also offers a few less tangible benefits and lessons learned.
Journal of Correctional Health Care, Vol. 9, No. 1, 53-61 (2002)
DOI: 10.1177/107834580200900106
Monday, November 2, 2009
Providers skeptical of meaningful use reimbursement process
Providers skeptical of meaningful use reimbursement process"Under a draft of potential measures released in September by the HIT Policy Committee, eligible providers would have to use CPOE (computerized physician order entry) for all orders, implement drug-drug, drug allergy and drug-formulary checks and maintain an up-to-date problem list of current and active diagnoses based on ICD-9 or SNOMED.
"
The issue of interoperability with hospitals in the local community is essential:
"...physicians from small practices often interact with more than five community hospitals and several labs, each with a different system. Doctors need to know that whatever electronic health record they buy will work with the systems the labs and hospitals have."
"
The issue of interoperability with hospitals in the local community is essential:
"...physicians from small practices often interact with more than five community hospitals and several labs, each with a different system. Doctors need to know that whatever electronic health record they buy will work with the systems the labs and hospitals have."
Sunday, November 1, 2009
WSJ: Video conferencing in Medicine
More Hospitals Are Using Video to Connect Patients With Specialists Far Away, Speeding Treatment
see the WSJ article here.Tuesday, October 6, 2009
Guest Post: Clinical Process in Pain Management
Clinical Process in Pain Management
It’s definitely not easy when you know you have a terminal disease like cancer. What’s worse is the fact that you know you’re going to suffer a painful death, one that will not come quickly but is drawn out and excruciating. Pain management is thus a very important part of palliative care, the kind that is provided to people who have been given just a few months to live at best, people who have lost all hope and for whom chemo and other treatment options are no longer effective. Even those patients who see a sliver of hope in the form of radiation and chemotherapy are in pain, because for this dreaded disease, even the treatment is a form of unbearable pain.
The clinical process in pain management includes the following steps:
• Assessing the pain and documenting its aspects – like how bearable it is and where it originates, if it is radiating or localized, if it is continuous or sporadic, and so on.
• Recognizing the triggers of pain – identifying the factors that cause the pain to flare up or intensify is important because it helps minimize trauma.
• Finding the cause of the pain – the triggers for the pain may be different from the cause. The cause may be a broken bone, but the trigger may be someone touching the injured area or moving it. It is imperative that the cause is identified and treated if the pain must be stopped for good.
• Assessing the risk in the situation – some treatment methods fail to take into account the risks involved. It’s important to assess all the risks, especially when treating people with prior medical conditions.
• Devising a care plan to manage the symptoms of pain – this is especially important when you’re looking after terminally ill patients who need long term pain management plans if they are to live out their last days in relative comfort.
• Treating the cause of the pain – the cause of the pain must be treated if possible, like in the case of broken bones or torn ligaments.
• Considering alternative action when the patient is unresponsive to one method of management – people respond differently to different drugs, so each person’s care plan has to be formulated with precision.
• Dealing with adverse drug reactions – some patients may be allergic to certain drugs, so you must ask the right questions before you begin treatment or pain management therapy.
• Continuously monitoring the situation to see if there has been any improvement – the patient has to be watched for signs, both of improvement and relapse. It’s important that non-verbal cues like grimaces and frowns be taken into consideration as well when caring for patients who are very ill.
Pain management is important in not just cancer but also in post-surgery situations and in acute care conditions. And when the clinical process is efficient, it makes it that much more bearable for the patient.
This guest article was written by Adrienne Carlson, who regularly writes on the topic of nurse practitioner schools . Adrienne welcomes your comments and questions at her email address: adrienne.carlson1@gmail.com
It’s definitely not easy when you know you have a terminal disease like cancer. What’s worse is the fact that you know you’re going to suffer a painful death, one that will not come quickly but is drawn out and excruciating. Pain management is thus a very important part of palliative care, the kind that is provided to people who have been given just a few months to live at best, people who have lost all hope and for whom chemo and other treatment options are no longer effective. Even those patients who see a sliver of hope in the form of radiation and chemotherapy are in pain, because for this dreaded disease, even the treatment is a form of unbearable pain.
The clinical process in pain management includes the following steps:
• Assessing the pain and documenting its aspects – like how bearable it is and where it originates, if it is radiating or localized, if it is continuous or sporadic, and so on.
• Recognizing the triggers of pain – identifying the factors that cause the pain to flare up or intensify is important because it helps minimize trauma.
• Finding the cause of the pain – the triggers for the pain may be different from the cause. The cause may be a broken bone, but the trigger may be someone touching the injured area or moving it. It is imperative that the cause is identified and treated if the pain must be stopped for good.
• Assessing the risk in the situation – some treatment methods fail to take into account the risks involved. It’s important to assess all the risks, especially when treating people with prior medical conditions.
• Devising a care plan to manage the symptoms of pain – this is especially important when you’re looking after terminally ill patients who need long term pain management plans if they are to live out their last days in relative comfort.
• Treating the cause of the pain – the cause of the pain must be treated if possible, like in the case of broken bones or torn ligaments.
• Considering alternative action when the patient is unresponsive to one method of management – people respond differently to different drugs, so each person’s care plan has to be formulated with precision.
• Dealing with adverse drug reactions – some patients may be allergic to certain drugs, so you must ask the right questions before you begin treatment or pain management therapy.
• Continuously monitoring the situation to see if there has been any improvement – the patient has to be watched for signs, both of improvement and relapse. It’s important that non-verbal cues like grimaces and frowns be taken into consideration as well when caring for patients who are very ill.
Pain management is important in not just cancer but also in post-surgery situations and in acute care conditions. And when the clinical process is efficient, it makes it that much more bearable for the patient.
This guest article was written by Adrienne Carlson, who regularly writes on the topic of nurse practitioner schools . Adrienne welcomes your comments and questions at her email address: adrienne.carlson1@gmail.com
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