Veille documentaire sur la téléréadaptation - CSCT

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Nov 15, 2013 (3 years and 8 months ago)

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1




Veille documentaire sur la téléréadaptation


Résultats du
mois d’
octobre 2012


1
.

Evolutionary approach to development of collaborative teleconsultation system for imaging medicine.

Czekierda L., Masternak T., Zieliński K.

IEEE Trans Inf Technol
Biomed 2012 16:4 (550
-
560)

MEDLINE

Abstract

This paper presents an evolution of a modern collaborative teleconsultation system called TeleDICOM over the period of severa
l
years. We show how new features (required from a medical point of view) can be provid
ed, which barriers have been identified,
and how these factors influence the system's architecture. A turning point in the evolution of our system was the formulation

of a
new architecture, fully facilitating service
-
oriented architecture paradigm guidelin
es. We therefore show how the knowledge and
experience gathered during utilization of previous versions of TeleDICOM positively stimulate procedures of service
-
based
system decomposition and business processes definition.



2
.

Telestroke
-

How does that wo
rk?

Boy S.

Perspect. Med. 2012 1
-
12: (77
-
79)

Embase

Abstract

The significance of cerebrovascular disorders is steadily increasing due to the demographic changes in western industrial
societies. Therefore the implementation of telemedical networks seems
tempting to improve deliverance of specialised stroke
care in non
-
urban areas. Networks like TEMPiS, located in the rural area of south
-
eastern Bavaria, have shown to deliver high
experienced stroke therapy to underserved areas. Mandatory for a high qualit
y of supply is the appropriate technical equipment.
Moreover, beside the teleconsultations, a continuous training should be performed. Mobile solutions allow more flexibility fo
r
the teleconsultants. © 2012 Elsevier GmbH. All rights reserved.



3
.

Understa
nding clinical work practices for cross
-
boundary decision support in e
-
health.

Tawfik H., Anya O., Nagar A.K.

IEEE Trans Inf Technol Biomed 2012 16:4 (530
-
541)

MEDLINE

Abstract

One of the major concerns of research in integrated healthcare information syst
ems is to enable decision support among
clinicians across boundaries of organizations and regional workgroups. A necessary precursor, however, is to facilitate the
construction of appropriate awareness of local clinical practices, including a clinician's a
ctual cognitive capabilities, peculiar
workplace circumstances, and specific patient
-
centered needs based on real
-
world clinical contexts across work settings. In this
paper, a user
-
centered study aimed to investigate clinical practices across three differ
ent geographical areas
-
the U.K., the UAE
and Nigeria
-
is presented. The findings indicate that differences in clinical practices among clinicians are associated with
differences in local work contexts across work settings, but are moderated by adherence to
best practice guidelines and the need
for patient
-
centered care. The study further reveals that an awareness especially of the ontological, stereotypical, and situated
practices plays a crucial role in adapting knowledge for cross
-
boundary decision support
. The paper then outlines a set of design
guidelines for the development of enterprise information systems for e
-
health. Based on the guidelines, the paper proposes the
conceptual design of CaDHealth, a practice
-
centered framework for making sense of clini
cal practices across work settings for
effective cross
-
boundary e
-
health decision support.

2




4
.

The French decree on telemedicine: A guarantee for doctors

Le décret français de télémédecine: Une garantie pour les médecins

Simon P., Pellitteri L.W.

Eur.
Res. Telemedicine 2012 1:2 (70
-
75)

Embase

Abstract

Telemedicine is a medical act conducted remotely via information and communication technologies. This definition was given
by the World Health Organisation (WHO) in 1997 and by French law on 21st July 2009
. In the French decree of 19th October
2010, five acts of telemedicine and the conditions of their implementation were defined. By publishing the Act and Decree of
telemedicine before 2011, France has followed the recommendations of the European Commission

in its communication of 4th
November 2008 to the Council and to the European Economic Committee, asking the Member States at the end of 2011 to have
examined and adapted their national legislation so that it allows wider access to telemedicine services. F
ollowing this regulatory
step, the French authorities have developed a national telemedicine deployment strategy comprising five priorities in order t
o
improve access to care. The first priority was better access to thrombolytic therapy for patients with a
n ischaemic stroke.
Telestroke can enable administration of treatment in less than 4.5 hours after the appearance of the first neurological signs
. The
second priority was to offer each French citizen a continuous healthcare in teleradiology. The third prio
rity was an improvement
of care in prisons. The fourth priority was the continuity of care at home by telemonitoring patients with chronic diseases.
The
last priority was the deployment of telemedicine in elderly care clinics. This national plan of telemed
icine will be deployed in
each French region under the authority of the regional health agencies. Medical health professionals, particularly physicians
,
needed to know their professional responsibility when they engaged in new healthcare organisations stru
ctured by telemedicine.
The Decree of 19th October 2010 provides the answers expected by health professionals and provides health professionals with
a
guarantee to their professional responsibility. The decree also guarantees quality medical practice for p
atients in accordance with
the rules of ethics and the rights of persons. It must be integrated into the new organisation of care structured by telemedi
cine.
Finally, it also allows the identification of the medical responsibilities engaged in the five act
s of telemedicine: teleconsultation,
tele
-
expertise, medical telemonitoring, remote medical help and emergency medical teleconsultations. © 2012 Published by
Elsevier Masson SAS.



5
.

Telemedicine: What legal framework should it be given?

Télémédecine:
Quel cadre juridique lui conférer ?

Mergnac K., Phillipe C., Moulin T., Binet J.
-
R.

Eur. Res. Telemedicine 2012 1:2 (66
-
69)

Embase

Abstract

In the French health code, the definition of telemedicine has been established in the HPST [Hospital, patients, sant
é et territories
-

Hospital, patients, health and territories] law. Telemedicine is defined as "a form of distance medical practice using inform
ation
and communications technology". The law also states that telemedicine "brings together, between themselves

or with a patient,
one or several health professionals, necessarily including a medical professional and, if applicable, other professionals pro
viding
care to the patient". Therefore, the act of telemedicine must be seen as an entirely medical act. The im
plementation of
telemedicine can enable diagnosis, ensure preventative or remedial followup, obtain specialist opinion, prepare therapeutic
decisions, enable prescription of products, enable prescription or provision of services or acts, or monitor patient

health. Just like
other medical acts, telemedicine creates the same obligations for the doctor and the patient enjoys the same rights as in any

traditional medical act. Non
-
compliance may incur the professional's liability. This article covers these two p
articular points and
illustrates how they can be incorporated into telemedicine. © 2012 Published by Elsevier Masson SAS.




7
.

Legal, deontological and ethical issues applied to telemedicine. A few insights about telestroke

Chopard J.
-
L., Hubert N., Mouli
n T., Bustos E.M.D.

Eur. Res. Telemedicine 2012 1:2 (61
-
65)

Embase

Abstract

Numerous technological advances in the field of medicine have given rise to numerous bioethical issues. Telemedecine is no
exception, and its development significantly changes the
patient
-
doctor relationship and has an impact on how doctors are
responsible for their patients and how patients are treated. It is also a practice that can greatly aid patients and compensa
te for
any shortcomings in the health care environment. However, t
his new technology may be unsettling for patients and so it is
3


critical that they fully understand the procedures and give their consent. More legal clarity about telemedicine is thus also

necessary. The responsibilities of the intervening doctors can be d
ifficult to define and generally speaking, doctors must take
responsibility for their actions. The requesting and consulted doctors have a complex relationship, where exchange and
discussion are critical. In the framework of more legal clarity, these discu
ssions and exchanges must be recorded and traceable.
Patient confidentiality should not be omitted either: to what extent and what kind of information is shared and with whom?
Although patients should have some say over what is transmitted, a balance must
be found between what information the patient
controls and restricts and what information must be transmitted. Furthermore, in view of certain French laws, there is a risk

of
excluding the patient or transmitting data without his or her knowledge. Tracing,

recording and storing this data is thus essential.
In terms of medicolegal liability, fear of litigation leads to the non
-
administration of necessary drugs (usually by inexperienced
physicians) and this in turn has negative consequences for the patient. T
elestroke is a good example. It can provide expert
"supervision" and clinical assessment of the patient and can alleviate this fear and thus reduce failure
-
to
-
treat rates. Despite its
great benefit, there is a lack or trust towards telestroke. For telestro
ke to become more effective, this distrust must be overcome
by including all staff in the process, as well as providing information sessions. Overall, telestroke has great positive pote
ntial and
facilitates administration of not only specific drugs but als
o the provision of numerous other services. Further advances can be
made in this field if the main hindrances are overcome. It is important to use technological advancements to their greatest
potential. Deploying this technology to all areas (especially re
mote rural hospitals), improving connectivity, enforcing quality
standards and building trust will help achieve this aim. © 2012 Published by Elsevier Masson SAS.



8
.

Phys Ther. 2012 Aug;92(8):1065
-
77. doi: 10.2522/ptj.20110277. Epub 2012 Apr 12.

Patient
-
centered integrated motor imagery delivered in the home with telerehabilitation to improve walking after stroke.

Deutsch JE, Maidan I, Dickstein R.

Source

Department of Rehabilitation and Movement Science, University of Medicine and Dentistry of New
Jersey, 65 Bergen St, SSB
723, Newark, NJ 07101, USA. deutsch@umdnj.edu

Abstract

BACKGROUND AND PURPOSE:

This case report describes the clinical reasoning process used to examine a person after stroke and intervene with a novel
integrated motor imagery tr
eatment designed for the rehabilitation of walking and delivered in the home through
telerehabilitation. The integrated motor imagery treatment consisted of patient
-
centered goal setting and physical practice
combined with motor and motivational imagery.

CASE DESCRIPTION:

The patient was a 38
-
year
-
old woman who had had a diffuse left subarachnoid hemorrhagic stroke 10 years earlier. She lived
independently in an assisted living complex and carried a straight cane during long walks or in unfamiliar environ
ments.
Examination revealed a slow gait speed, reduced walking endurance, and decreased balance confidence. Although she was in the
chronic phase, patient
-
centered integrated motor imagery was predicted to improve her community mobility. Treatment sessions

of 45 to 60 minutes were held 3 times per week for 4 weeks. The practiced tasks included transitioning from sitting to standi
ng,
obstacle clearance, and navigation in interior and exterior environments; these tasks were first executed and then imagined a
t

ratios of 1:5. Task execution allowed the creation of a scene based on movement observation. Imagery scenarios were
customized to address the patient's goals and observed movement problems. Motivational elements of arousal, problem solving,
and reward wer
e embedded in the imagery scenarios. Half of the sessions were provided on site, and the remaining sessions were
delivered remotely. Seven sessions were delivered by the clinician in the home, and 5 sessions were delivered using
telerehabilitation.


OUTCOM
ES:

Improvements in motor imagery ability, gait parameters, and balance were observed after training. Most gains were retained at

the 3
-
month follow
-
up. Compared with on
-
site delivery, the telerehabilitation sessions resulted in less therapist travel time

and
cost, as well as shorter therapy sessions.

DISCUSSION:

The delivery of integrated motor imagery practice for walking recovery was feasible both on site and remotely.

PMID: 22499891



9
.

IEEE Trans Inf Technol Biomed. 2012 Jul;16(4):586
-
97. doi: 10.
1109/TITB.2012.2191295. Epub 2012 Mar 19.

Link technologies and BlackBerry mobile health (mHealth) solutions: a review.

Adibi S.

4


The number of wearable wireless sensors is expected to grow to 400 million by the year 2014, while the number of operational
mo
bile subscribers has already passed the 5.2 billion mark in 2011. This growth results in an increasing number of mobile
applications including: Machine
-
to
-
Machine (M2M) communications, Electronic
-
Health (eHealth), and Mobile
-
Health
(mHealth). A number of e
merging mobile applications that require 3G and 4G mobile networks for data transport relate to
telemedicine, including establishing, maintaining, and transmitting health
-
related information, research, education, and training.
This review paper takes a clo
ser look at these applications, specifically with regard to the healthcare industry and their
underlying link technologies. The authors believe that the BlackBerry platform and the associated infrastructure (i.e., Black
Berry
Enterprise Server) is a logical

and practical solution for eHealth, mHealth, sensor and M2M deployments, which are considered
in this paper.

PMID: 22453643 [PubMed
-

indexed for MEDLINE]



10
.

Behav Res Ther. 2012 Sep;50(9):565
-
70. doi: 10.1016/j.brat.2012.05.009. Epub 2012 Jun 4.

A
randomized pilot trial comparing videoconference versus face
-
to
-
face delivery of behavior therapy for childhood tic disorders.

Himle MB, Freitag M, Walther M, Franklin SA, Ely L, Woods DW.

Source

University of Utah, USA. michael.himle@utah.edu

Abstract

Comprehensive Behavioral Intervention for Tics (CBIT) has been shown to be effective for reducing tics in children with chron
ic
tic disorder. Unfortunately, there remain significant barriers to dissemination. The aim of the current study was to examine
the

effectiveness of CBIT delivered over videoconference. Twenty children were randomly assigned to receive CBIT over
videoconference or via traditional face
-
to
-
face delivery. Results show that both treatment delivery modalities resulted in
significant tic re
duction with no between group differences. Furthermore, acceptability and therapist
-
client alliance ratings were
strong for both groups. Together, these results suggest that videoconference is a viable option for disseminating CBIT.

Copyright © 2012 Els
evier Ltd. All rights reserved.

PMID: 22743661 [PubMed
-

indexed for MEDLINE]



11
.

Behav Res Ther. 2012 Sep;50(9):544
-
50. doi: 10.1016/j.brat.2012.05.003. Epub 2012 May 18.

Therapeutic alliance in guided internet
-
delivered cognitive behavioural treatment

of depression, generalized anxiety disorder and
social anxiety disorder.

Andersson G, Paxling B, Wiwe M, Vernmark K, Felix CB, Lundborg L, Furmark T, Cuijpers P, Carlbring P.

Source

Department of Behavioural Sciences and Learning, Swedish Institute for Di
sability Research, Linköping University, Sweden.
Gerhard.Andersson@liu.se

Abstract

Guided internet
-
delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the
mechanisms of change are largely unknown. T
herapeutic alliance is a factor that has been studied in many psychotherapy trials,
but the role of therapeutic alliance in ICBT is less well known. The present study investigated early alliance ratings in thr
ee
separate samples. Participants from one samp
le of depressed individuals (N = 49), one sample of individuals with generalized
anxiety disorder (N = 35), and one sample with social anxiety disorder (N = 90) completed the Working Alliance Inventory
(WAI) modified for ICBT early in the treatment (weeks
3
-
4) when they took part in guided ICBT for their conditions. Results
showed that alliance ratings were high in all three samples and that the WAI including the subscales of Task, Goal and Bond h
ad
high internal consistencies. Overall, correlations between

the WAI and residualized change scores on the primary outcome
measures were small and not statistically significant. We conclude that even if alliance ratings are in line with face
-
to
-
face
studies, therapeutic alliance as measured by the WAI is probably l
ess important in ICBT than in regular face
-
to
-
face
psychotherapy.

Copyright © 2012 Elsevier Ltd. All rights reserved.

PMID: 22728647 [PubMed
-

indexed for MEDLINE]


12.

An Improved Authentication Scheme for Telecare Medicine Information Systems.

Wei, Jianghong; Hu, Xuexian; Liu, Wenfen;

Journal of Medical

Systems, 2012 Dec; 36 (6): 3597
-
604 ISSN: 0148
-
5598

CINAHL AN: 2011693573

http://searc
h.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2011693573&site=ehost
-
live



5




15.

Understanding the need of health care providers for teleconsultation and technological attributes in relation to the acceptan
ce of
teleconsultation in Malaysia: a mixed met
hods study.

Maarop N., Win K.T.

J Med Syst 2012 36:5 (2881
-
2892)

Abstract

The aim of this study was to explore the importance of service need along with perceived technology attributes in potentially

influence the acceptance of teleconsultation. The study
was conducted based on the concurrent triangulation design involving
qualitative and quantitative study methods. These entailed interviews with key informants and questionnaires survey of health

care providers who practiced in the participating hospitals i
n Malaysia. Thematic analysis involving iterative coding was
conducted on qualitative data. Scale reliability test and hypothesis testing procedures were performed on quantitative data.
Subsequently, both data were merged, compared and interpreted. In part
icular, this study utilized a qualitative priority such that a
superior emphasis was placed on the qualitative method to demonstrate an overall understanding. Based on the responses of 20
key informants, there was a significant need for teleconsultation as

a tool to extend health services to patients under constrained
resources and critical conditions. Apparently, the latest attributes of teleconsultation technology have generally met users'

expectation but rather perceived as supportive facets in encouragi
ng the usage. Concurrently, based on the survey engaging 72
health care providers, teleconsultation acceptance was statistically proven to be strongly associated with service need and n
ot
originated exclusively from the technological attributes. Additional
ly, the results of this study can be used to promote
teleconsultation as an effective means in delivering better health services. Thus, the categories emerged from this study may

be
further revised and examined for explaining the acceptance of teleconsulta
tion technology in other relevant contexts.




22.

J Med Syst. 2012 Oct;36(5):3173
-
6. Epub 2011 Nov 24.

E
-
Health: a global approach with extensive semantic variation.

Moghaddasi H, Asadi F, Hosseini A, Ebnehoseini Z.

Source

Health Information Management,
Shahid Beheshti University of Medical Sciences, Tehran, Iran. moghaddasi@sbmu.ac.ir

Abstract

In recent years, there has been considerable attention towards the development of information and communication technology
(ICT) in health care delivery known as '
E
-
Health'. The term "E
-
Health" is almost a new concept and the E
-
Health projects mainly
aim to improve service delivery to people, though different countries might have different approaches in using E
-
Health. The
focus of this study is to review factors in
fluencing the development of E
-
Health projects, as these factors could lead to an
extensive semantic variation. This study reviews the E
-
Health status in different countries based on existing reports and
documents about E
-
health projects in developed and d
eveloping countries and also based on the reports and documents provided
by WHO, International Telecommunication Union (ITU); and World Bank. The review of the documents showed that the E
-
Health status in different countries is depended upon three key fact
ors including the potential of ICT, economic capacity and the
level of health status. The review of the documents indicated that there might be different meanings for the concept of E
-
Health
in different countries, and the semantic variation in E
-
Health co
ncept is related to the level of E
-
Health developments and
implementations. Therefore, developing a clear definition of E
-
Health is needed.

PMID: 22113437 [PubMed
-

indexed for MEDLINE]


24.

Telepsychogeriatrics: A new horizon in the care of mental health
problems in the elderly

Ramos
-
Ros R., Mateos R., Lojo D., Conn D.K., Patterson T.

Int. Psychogeriatr. 2012 24:11 (1708
-
1724)

Embase

Abstract

Background: The use of telemedicine for the care of mental health problems has developed significantly over the las
t decade
thanks to the emergence of a number of stable telepsychiatry programs in many countries. Parallel to this development, this c
are
modality has also targeted specific populations with higher difficulty in gaining access to mental health services suc
h as the
elderly. Telepsychogeriatrics is expected to have an increasing role in providing care to geographically isolated rural
6


communities, with a particular focus on long
-
term care facilities, in light of the high prevalence of psychiatric disorders in
these
centers and the lack of available specialized care. Methods: A thorough search of the literature was conducted using Medline,

Web of Science, and PsychINFO databases in order to gather available evidence on the applicability of telepsychiatry,
specif
ically the use of videoconferencing for remote consultation, in the elderly population with mental disorders. A succinct
description of the selected studies is given along with a general reflection on the state
-
of
-
the
-
art in the field of psychogeriatric
cl
inical practice and research. Results: Research on the use of telemedicine in this age group has taken into account their spe
cial
characteristics, and has focused on demonstrating its applicability, the acceptance and satisfaction of elderly users and the
i
r
healthcare providers, the possibility of carrying out cognitive and diagnostic assessments, and the efficiency of these progr
ams.
Conclusions: Despite limited experience, telepsychogeriatrics appears to be a viable option, well accepted by patients, incl
uding
those having dementia. More systematized studies are needed in this new field based on larger sample sizes, including
comparison with traditional consultations and assessment of the clinical outcomes. © International Psychogeriatric Associatio
n
2012.




28.

NHS boards see telehealth only as a means of saving money, warns expert.

Limb M.

BMJ 2012 345: (e4633)

MEDLINE

No abstract available


29.

Remote monitoring for continuous peritoneal dialysis

Rosner M.H., Ronco C.

Contrib. Nephrol. 2012 178: (68
-
73)

MEDLINE

Abstract

Peritoneal dialysis affords patients the luxury of independence and with this an improved quality of life. However, patients
on
peritoneal dialysis still require monthly visits with the care team to assess the quality of therapy (volume a
nd blood pressure
control, solute clearance, attainment of metabolic goals, and others). Furthermore, a critical aspect of therapy is that the
patient
must actively monitor their therapy with daily recordings of weight, blood pressure, and fluid removal. R
emote monitoring of the
patient on peritoneal dialysis offers the benefits of real
-

time monitoring and recording of the therapy as well as an interactive
interface with the care team that may allow both acute 'trouble shooting' for problems as well as a m
eans to interact with the
patient for their monthly evaluation. This remote monitoring allows assurance of patient safety through surveillance of criti
cal
portions of the treatment as well as the ability to monitor compliance with prescribed therapy and au
tomated collection of
treatment data. Recent advances in telemedicine, telemonitoring, remote network access and sensor technologies have made such

remote monitoring of peritoneal dialysis therapy feasible. Copyright © 2012 S. Karger AG.



30.

eHealth: eas
ing translation in health care.

Geissbühler A.

Swiss Med Wkly 2012 142: (w13599)

MEDLINE

Abstract

Our complex healthcare systems are fragmented, and their functioning, both in terms of efficiency and quality, are plagued by

multiple discontinuities. eHealt
h has the potential to ease transitions between the many settings and stakeholders of healthcare.
eHealth can improve the continuity of healthcare information flow, can facilitate the re
-
engineering of care processes so that they
become much more patient
-
o
wned and patient
-
controlled, and can enable better ways of accessing and producing care. Such
capabilities evolve with the development of our information and knowledge
-
based society, reflected by the various generations
of the world
-
wide
-
web. Starting with

the "read
-
only Web" where the main task was to give access to health information, it has
evolved into the "social Web" and provides support of patient
-
centred, collaborative care, and is reaching a stage where
pervasive computing tools can intelligently p
artner with citizens to help them take better care of their health.

7





34.

Telemedicine to improve access to specialized care for patients with cystic fibrosis

Appiah
-
Kubi G., Bhide R., Flewelling C., Tsang A., Tullis E., Westell S., Zinger S.

Pediatr. Pul
monol. 2012 47: (444
-
445)

Embase

Abstract

The Toronto Adult Cystic Fibrosis (CF) Program at St Michael's Hospital was established in 1992 and is North America's larges
t
adult CF program. Two satellite CF clinics were established for patients in northern
Ontario communities hundreds of miles
away. Frequent follow up in multidisciplinary CF clinics is known to improve patient outcomes. However, satellite clinics do
not
allow access to the entire multidisciplinary team, as reimbursement is limited for expens
es related to physician visits. For
appointments at the host hospital scheduling limitations such as accommodating patients' work or school responsibilities,
availability of space, the CF physician's schedule, and inclement weather frequently led to last m
inute clinic cancellations.
Objectives: The main goals of this initiative were to improve patient care and education by utilizing videoconferencing. Pati
ents
would come to Toronto once a year, attend satellite clinics twice a year and have a telemedicine a
ppointment annually. Methods:
In July 2010, monthly telemedicine multidisciplinary CF clinics were established to address the barriers that impede access t
o
care. Patients were interviewed by the local nurse and spirometry and bloodwork were done. Results
were sent by FAX to the
Toronto clinic and the patients were able to see team members by video link. Results: The telemedicine conference visit was
used in two major ways
-

for routine clinic visits and for episodic illness. To date, there have been 71 pat
ients seen by
telemedicine conference with 22 monthly clinics held and 10 patients seen outside of the monthly clinics. As time passed
clinicians became more experienced with the format and used the telemedicine link in increasingly diverse ways. Several
t
elemedicine clients in remote locations were cared for on home intravenous therapy. One ventilated client was being considere
d
for transplant while hospitalized 800 miles away and was monitored and coached via telemedicine by both the CF and transplant

phy
sicians. For a newly diagnosed client the CF doctor used telehealth to explain how to use enzymes. The nurse practitioner
was able to present diagrams of the pathophysiology of cystic fibrosis by video for the patient to see. The physiotherapist u
sed
telem
edicine to demonstrate correct technique for airway clearance. The mother of a CF child commented that the drive to the
telehealth studio took 15 minutes compared with a 10 hour trip to the Toronto clinic. One patient explained that the trip to
Toronto mea
nt interrupting her life
-
sustaining therapies including masks, physio and exercise. Discussion: Telemedicine
improved patient care, reduced patient costs and improved inter
-
professional collaboration. We were able to strengthen
relationships with community

partners by incorporating visits with local care teams. The telemedicine visits express our client
-
centred approach to care by maintaining interprofessional collaboration with the CF team while saving the client time and tra
vel
costs. Future plans include

continuing to promote attendance at telehealth and possibly considering specialized clinics such as
CFRD clinics that could be held via telehealth.



35.

Continuity, but at what cost? The impact of telemonitoring COPD on continuities of care: A qualitativ
e study

Fairbrother P., Pinnock H., Hanley J., McCloughan L., Sheikh A., Pagliari C., McKinstry B.

Prim. Care Respir. J. 2012 21:3 (322
-
328)

Embase

Abstract

Background: Continuity of care is widely regarded as an important marker of quality in the management of patients with long
-
term conditions. New services that integrate telemonitoring into care pathways have potential to change aspects of continuity

in
bot
h positive and negative ways. Aims: A telemonitoring service for patients with chronic obstructive pulmonary disease
(COPD) was introduced in Lothian, Scotland, in 2009. A qualitative study, nested within the TELESCOT COPD randomised
control trial, was und
ertaken to explore the views of patients and professionals on telemonitoring. The perceived impact of
telemonitoring on continuity of care was investigated as part of the research. Methods: Semi
-
structured interviews were
undertaken with 38 patients (47% m
ale, mean age 67.5 years). A maximum variation sample in relation to age, sex, socio
-
economic background, disease severity, and compliance with telemonitoring was recruited. Thirty
-
two stakeholders (healthcare
professionals and managers) were interviewed.
Transcribed coded data were analysed thematically using the framework
approach. Interpretation was supported by multidisciplinary discussion. Results: Patients and healthcare professionals consid
ered
8


that relationship
-
based continuity of care was important

in the delivery of telemonitoring services. Managers placed emphasis on
improved continuity of clinical management as a means of reducing healthcare costs. However, professionals described many
operational challenges arising from the 'bolting
-
on' of telem
onitoring provision to existing usual care provision which, they
considered, resulted in the proliferation of additional managerial discontinuities. Conclusions: Managers and healthcare
professionals face major challenges in meeting demands for both relati
onship continuity and continuity of clinical management
in the development of telemonitoring services. © 2012 Primary Care Respiratory Society UK. All rights reserved.



36.

The tyranny of distance: Telemedicine for the critically ill in rural Australia

Bo
ots R.J., Singh S.J., Lipman J.

Anaesth. Intensive Care 2012 40:5 (871
-
874)

Embase

A case of severe sepsis with multi
-
organ failure needing complex support was deemed too ill for transfer to a major centre.
Telemedicine allowed direct patient review, colla
borative advice and collegial support with maintained healthcare standards
while avoiding long distance transfer from his home and family.



41.

Let's get serious about telehealth.

Easton J.

Health Serv J 2012 122:6311 (18)

MEDLINE

No abstract available



Bien que cet article récent ne concerne pas seulement la téléréadaptation, j’ai cru pertinent de l’inclure à la liste.

44.

Disabil Rehabil.

2012;34(2):167
-
73. Epub 2011 Sep 22.

Assessment of organizational readiness for e
-
health in a rehabilitation centre.

Touré M
,
Poissant L
,
Swaine BR
.

Source

Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Qc, Canada.

Abstract

PURPOSE:

The aims of this study were to assess organizational readiness for e
-
health among the s
taff of an out
-
patient rehabilitation centre
and to identify the personal characteristics of potential users that may have influenced readiness.

METHODS:

A cross
-
sectional study was conducted with 137 clinicians, 28 managers, and 47 nonclinical staff in a

rehabilitation centre in
Montreal, Quebec, Canada. All participants completed a self
-
administered questionnaire assessing organizational readiness for e
-
health. The measure contained three subscales: Individual, Organizational and Technological. Data were

also collected on the
users' profile, use of technologies and typical response to new information.

RESULTS:

Generally, participants considered themselves ready to adopt e
-
health in their work (X

=

73.8%, SD

=

8.5) and they also had a
favorable view of th
e technologies in place (X

73.8%, SD

=

7.2). However, they perceived the center as being only moderately
ready (X

66.6%, SD

=

9.8) for e
-
health changes. Perceived workload and position/duties in the organization were found to have
an impact on readiness fo
r e
-
health.

CONCLUSIONS:

These results underscore the importance of addressing organizational readiness for change as a multidimensional concept. Base
d
on these results, implementation strategies tailored to the specific pr
ofile of a rehabilitation
organization were identified.

PMID: 21936712



9


45.

Cardiol J. 2012;19(3):243
-
8.

How to do: telerehabilitation in heart failure patients. Piotrowicz E.

Department of Cardiac Rehabilitation and Noninvasive Electrocardiology, Institute of Cardiology, Warsaw
, Poland.

Abstract

According to the present guidelines for heart failure patients, regular exercise training has obtained the class of recommend
ation
I, level of evidence A. Despite the benefits of cardiac rehabilitation, many heart failure patients are i
nactive. Common patient's
rejection of existing forms of rehabilitation and limitations resulting from the disease itself hinder the outpatient cardiac

rehabilitation. That is why home telerehabilitation seems to be the optimal form of physical activity fo
r heart failure patients.

PMID: 22641542 Free Article


Bien que cet article récent ne concerne pas seulement la téléréadaptation, j’ai cru pertinent de l’inclure à la liste.

46.

Disabil Rehabil.

2012;34(2):167
-
73. Epub 2011 Sep 22.

Assessment of organizational readiness for e
-
health in a
rehabilitation centre.

Touré M
,
Poissant L
,
Swaine BR
.

PURPOSE:

The aims of this study were to assess organizational readiness for e
-
health among the staff of an
out
-
patient rehabilitation centre
and to identify the personal characteristics of potential users that may have influenced readiness.

METHODS:

A cross
-
sectional study was conducted with 137 clinicians, 28 managers, and 47 nonclinical staff in a rehabilita
tion centre in
Montreal, Quebec, Canada. All participants completed a self
-
administered questionnaire assessing organizational readiness for e
-
health. The measure contained three subscales: Individual, Organizational and Technological. Data were also colle
cted on the
users' profile, use of technologies and typical response to new information.

RESULTS:

Generally, participants considered themselves ready to adopt e
-
health in their work (X

=

73.8%, SD

=

8.5) and they also had a
favorable view of the technolog
ies in place (X

73.8%, SD

=

7.2). However, they perceived the center as being only moderately
ready (X

66.6%, SD

=

9.8) for e
-
health changes. Perceived workload and position/duties in the organization were found to have
an impact on readiness for e
-
health.

CONCLUSIONS:

These results underscore the importance of addressing organizational readiness for change as a multidimensional concept. Base
d
on these results, implementation strategies tailored to the specific profile of a rehabilitation organization were

identified.

PMID: 21936712



48.

S
troke. 2012 Aug;43(8):2168
-
74. Epub 2012 May 24.

Effects of telerehabilitation on physical function and disability for stroke patients: a randomized, controlled trial.

Chumbler NR, Quigley P, Li X, Morey M, Rose D , San
ford J, Griffiths P, Hoenig H.

Source

VA HSR&D Center of Excellence on Implementing Evidence
-
Based Practice, Richard L. Roudebush VAMC, Indianapolis, IN
46202
-
2884, USA. nchumble@iupui.edu

Abstract

BACKGROUND AND PURPOSE:

To determine the effect of a mult
ifaceted stroke telerehabilitation (STeleR) intervention on physical function, and secondarily on
disability, in veterans poststroke.

METHODS:

10


We conducted a prospective, randomized, multisite, single
-
blinded trial in 52 veterans with stroke from 3 Vetera
ns Affairs
medical centers. Veterans with a stroke in the preceding 24 months were randomized to the STeleR intervention or usual care.
The STeleR intervention consisted of 3 home visits, 5 telephone calls, and an in
-
home messaging device provided over 3 m
onths
to instruct patients in functionally based exercises and adaptive strategies. Usual care participants received routine rehabi
litation
care as prescribed by their physicians. The primary outcome measures were improvement in function at 6 months, measu
red by
both the motor subscale of the Telephone Version of Functional Independence Measure and by the function scales of the Late
-
Life Function and Disability Instrument.

RESULTS:

The 2 complementary primary outcomes (Late
-
Life Function and Disability Ins
trument Function and Telephone Version of
Functional Independence Measure) improved at 6 months for the STeleR group and declined for the usual care group, but the
differences were not statistically significant (P=0.25, Late
-
Life Function and Disability In
strument; P=0.316). Several of
secondary outcomes were statistically significant. At 6 months, compared with the usual care group, the STeleR group showed
statistically significant improvements in 4 of the 5 Late
-
Life Function and Disability Instrument dis
ability component subscales
(P<0.05), and approached significance in 1 of the 3 Function component subscales (P=0.06).

CONCLUSIONS:

The STeleR intervention significantly improved physical function, with improvements persisting up to 3 months after complet
ing
the intervention. STeleR could be a useful supplement to traditional poststroke rehabilitation given the limited resources
available for in
-
home rehabilitation for stroke survivors.

PMID: 22627983



Sur le Web

:

Un autre pas vers l'intégration des TIC
au Centre de réadaptation Lucie
-
Bruneau
-

Lancement du CRLB
-
Virtuel : un projet
novateur alliant le Web 2.0, la téléréadaptation et les services à distance


http://www.newswire.ca/fr/story/1053625/un
-
autre
-
pas
-
vers
-
l
-
integration
-
des
-
tic
-
au
-
centre
-
de
-
readaptation
-
lucie
-
bruneau
-
lancement
-
du
-
crlb
-
virtuel
-
un
-
projet
-
novateur
-
alliant
-
le
-
web
-
2
-
0
-
la
-
tel




Initiative du
Comité de développement des pratiques cliniques en téléréadaptation
, coordonné par Johanne
Lambert, chargée de projet (IRDPQ)

Recherche documentaire effectuée par Ann Murchison, bibliothécaire,
CIGI, IRDPQ

Sélection réalisée par Geneviève Bastien, physiothérapeute et coordonnatrice clinique au Programme des grands
brûlés de la Direction des services à la clientèle adultes
-
aînés, Louis Deschênes, spécialiste en réadaptation
visuelle au Programme d
e déficience visuelle de la Direction des services à la clientèle et

Ann Murchison,
bibliothécaire