Application and evaluation of high speed data transfer for decision support in remote health care.

Armstrong, Iain

Abstract

This thesis describes the use of telemedicine and medical decision support facilities to improve remote health care in three different scenarios viz. remote communities, merchant marine vessels and offshore installations. In each scenario, telemedical technology and new operational procedures were devised and applied, taking into account the health care requirements of the remote population and the medical education of the remote practitioners. In the community scenario, videoconferencing, teleradiology and telepresence were used to improve clinical information transfer between the remote general practitioner and Accident and Emergency consultants. The telemedical link was used to treat 120 patients and saved the transfer of 70 of these patients to the large urban hospital during the clinical trial period. Measures of satisfaction of the functionality and quality of the videoconferencing and teleradiology were determined and evaluations made. The merchant marine and offshore scenarios used the existing telecommunications infrastructure to provide an improved telemedical service. Clinical data collection protocols, procedures and medical assessment questionnaires were used to increase the relevant clinical information transfer. Digital and video cameras were implemented to increase the information that could be sent to the specialist practitioner in an emergency. In the merchant marine environment, a specific software application, appropriate to the medical service was implemented, connecting the medical attendant on board with the shore based medical decision support facilities and services. The offshore medic received medical decision support from the shore-based doctor. This service has been improved through the addition of telemedicine technologies and clinical data collection and transfer procedures. Remote practitioners, patients and specialist medical care providers were found to be satisfied with improvements in remote health care service provision in either of these scenarios. Telemedical technology and its application were found not to be the inhibiting factors in the application and use of telemedicine and medical decision support in remote health care. In each scenario, cultural, managerial and organisation issues played a significant role in the success or failure of telemedicine. The medico-legal issues were found to be over-rated as barriers to dissemination of telemedicine in supporting remote health care. Medical decision support was shown to be key component in the provision of remote health care together with: Suitably trained personnel at both sites. Efficient communications. New procedures developed for telemedicine implementation. Specialist availability. Clinical information transfer. Knowledge of the medical indent. Continuing research and analysis to improve the system/service provision.

Citation

ARMSTRONG, I. 2001. Application and evaluation of high speed data transfer for decision support in remote health care. Robert Gordon University, PhD thesis. Hosted on OpenAIR [online]. Available from: https://doi.org/10.48526/rgu-wt-2807285

• Thesis Type: Thesis
• Deposit Date: May 14, 2025
• Publicly Available Date: May 14, 2025
• DOI: https://doi.org/10.48526/rgu-wt-2807285
• Public URL: https://rgu-repository.worktribe.com/output/2807285
• Award Date: Jan 31, 2001