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      Development and Operation of a Video Teleconsultation System Using Integrated Medical Equipment Gateway: a National Project for Workers in Underserved Areas

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Worker health centers and health zones provide occupational healthcare services to workers in underserved areas of industrial health. Health zones cannot counsel workers on occupational disease prevention; worker health center personnel have to provide such services through in-person visits. Video teleconsultation can increase the accessibility of high-quality services to workers who visit health zones and improve professional personnel’s efficiency. This study aimed to develop a system and an infrastructure that could facilitate video teleconsultation services between worker health centers and health zones, and analyze the services’ operation status. A video teleconsultation process based on the role of local and remote institutions was designed. Based on the designed services, a web system supporting teleconsultation and an integrated gateway guaranteeing the interface with medical equipment in the web environment was developed. After analyzing the working environment, an infrastructure consisting of networks, video equipment, medical equipment, and servers necessary for teleconsultation was designed. Statistical results from the developed system and a satisfaction survey conducted by the Korea Occupational Safety and Health Agency were used to analyze the video teleconsultation services’ operation status. A system, gateway, and hardware infrastructure within 21 worker health centers and 21 health zones has been operating this service since January 1, 2018. Over two years, the total number of teleconsultation service users was 4979, and the total number of questionnaire respondents was 1270. The total number of service activities was 6388 and total satisfaction was rated as 4.58 (± 0.59) out of 5. In this study, video teleconsultation services were evaluated as being very satisfactory. In particular, service accessibility and local medical personnel service were rated highly, demonstrating that the developed system and infrastructure were well designed according to the goals of the project.

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          Most cited references 43

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          Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey.

          We compared health status, access to care, and utilization of medical services in the United States and Canada and compared disparities according to race, income, and immigrant status. We analyzed population-based data on 3505 Canadian and 5183 US adults from the Joint Canada/US Survey of Health. Controlling for gender, age, income, race, and immigrant status, we used logistic regression to analyze country as a predictor of access to care, quality of care, and satisfaction with care and as a predictor of disparities in these measures. In multivariate analyses, US respondents (compared with Canadians) were less likely to have a regular doctor, more likely to have unmet health needs, and more likely to forgo needed medicines. Disparities on the basis of race, income, and immigrant status were present in both countries but were more extreme in the United States. United States residents are less able to access care than are Canadians. Universal coverage appears to reduce most disparities in access to care.
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            This systematic review of mixed methods studies focuses on factors that can facilitate or limit the implementation of information and communication technologies (ICTs) in clinical settings. Systematic searches of relevant bibliographic databases identified studies about interventions promoting ICT adoption by healthcare professionals. Content analysis was performed by two reviewers using a specific grid. One hundred and one (101) studies were included in the review. Perception of the benefits of the innovation (system usefulness) was the most common facilitating factor, followed by ease of use. Issues regarding design, technical concerns, familiarity with ICT, and time were the most frequent limiting factors identified. Our results suggest strategies that could effectively promote the successful adoption of ICT in healthcare professional practices.
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              Geographic access to health care for rural Medicare beneficiaries.

              Patients in rural areas may use less medical care than those living in urban areas. This could be due to differences in travel distance and time and a utilization of a different mix of generalists and specialists for their care. To compare the travel times, distances, and physician specialty mix of all Medicare patients living in Alaska, Idaho, North Carolina, South Carolina, and Washington. Retrospective design, using 1998 Medicare billing data. Travel time was determined by computing the road distance between 2 population centroids: the patient's and the provider's zone improvement plan codes. There were 2,220,841 patients and 39,780 providers in the cohort, including 6,405 (16.1%) generalists, 24,772 (62.3%) specialists, and 8,603 (21.6%) nonphysician providers. There were 20,693,828 patient visits during the study. The median overall 1-way travel distance and time was 7.7 miles (interquartile range 1.9-18.7 miles) and 11.7 minutes (interquartile range 3.0-25.7 minutes). The patients in rural areas needed to travel 2 to 3 times farther to see medical and surgical specialists than those living in urban areas. Rural residents with heart disease, cancer, depression, or needing complex cardiac procedures or cancer treatment traveled the farthest. Increasing rurality was also related to decreased visits to specialists and an increasing reliance on generalists. Residents of rural areas have increased travel distance and time compared to their urban counterparts. This is particularly true for rural residents with specific diagnoses or those undergoing specific procedures. Our results suggest that most rural residents do not rely on urban areas for much of their care.
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                Author and article information

                Contributors
                hspark@bit.kr
                Journal
                J Med Syst
                Journal of Medical Systems
                Springer US (New York )
                0148-5598
                1573-689X
                1 October 2020
                2020
                : 44
                : 11
                Affiliations
                [1 ]Digital Healthcare Department, BIT Computer Co Ltd, Seoul, Republic Of Korea
                [2 ]GRID grid.258803.4, ISNI 0000 0001 0661 1556, Department of Medical Informatics, , Kyungpook National University, ; Daegu, Republic Of Korea
                [3 ]GRID grid.415488.4, ISNI 0000 0004 0647 2869, Finance Programs Department, , Korea Occupational Safety & Health Agency, ; Ulsan, Republic Of Korea
                [4 ]Elecmarvels Co Ltd, Daegu, Republic Of Korea
                Article
                1664
                10.1007/s10916-020-01664-w
                7529321
                33006060
                © Springer Science+Business Media, LLC, part of Springer Nature 2020

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                Categories
                Patient Facing Systems
                Custom metadata
                © Springer Science+Business Media, LLC, part of Springer Nature 2020

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