Implementation and evaluation of a multifunctional telemedicine system in NTUH
Journal
International Journal of Medical Informatics
Journal Volume
61
Journal Issue
2-3
Pages
175-187
Date Issued
2001
Author(s)
Abstract
In this article, we proposed a multifunctional telemedicine system supporting both telediagnosis and teleconsultation services. We attempted not only to insure that the implementation of this system satisfied most requirements, but also to evaluate the impact of the system. With regard to system architecture, we designed a unified multimedia database to store all types of data and used two kinds of network (ATM and ISDN) for different possible applications. As for data transmission, the REFRESH and PREFETCH mechanisms were implemented to enhance data transfer efficiency. A total of 1107 consultations employing the telemedicine system were performed during the past 3 years. This technology was used most frequently for radiology consultation (32.7%, n=362) and ultrasonic examination (19.5%, n=216). An evaluation of the impact on diagnosis (507 valid cases) indicated that the diagnosis in 80 cases (15.78%) were altered on the basis of second opinions from a medical center; and the number of patients transferred to the medical center was reduced from 24 (4.7%) to eight cases. Most of the rural-site physicians (97%) thought that they did benefit from specialists' experience and knowledge via the telemedicine system. Based on 431 valid questionnaires, the number of the patients with confidence in the telemedicine system at their local healthcare center increased from 72.6% to 87.5%. Overall, more than 90% of patients and physicians believed that the system was valuable and provided satisfactory services. ? 2001 Elsevier Science Ltd. All rights reserved.
Subjects
ATM; ISDN; Telemedicine
SDGs
Other Subjects
Asynchronous transfer mode; Data transfer; Database systems; Medical computing; Multimedia systems; Telediagnosis; Telemedicine; article; audiovisual equipment; computer network; consultation; data base; diagnostic accuracy; human; information processing; information system; medical information; medical record; patient information; patient satisfaction; physician; priority journal; rural area; technology; telecommunication; Adolescent; Adult; Aged; Child; Child, Preschool; Computer Systems; Databases, Factual; Diagnosis, Differential; Female; Humans; Infant; Male; Middle Aged; Patient Satisfaction; Rural Health Services; Software; Taiwan; Telemedicine
Type
journal article
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