Introduction: The coronavirus disease 2019 (COVID-19) pandemic prompted a shift from standard in-person consultation to non-patient contact methods such as telemedicine. To our knowledge, there was no published a priori evaluation of the telemedicine readiness and acceptance among the medical staff of the Philippine General Hospital (PGH) before implementing the institution’s telemedicine program. The lack of this vital pre-implementation step is understandable given the unprecedented crisis. However, if telemedicine programs will continue in the post-quarantine period, it is crucial to determine the facilitators and barriers to the use of telemedicine. Objective: This study determined the level of readiness and acceptance for telemedicine as an alternative method for patient consultation during the COVID-19 pandemic and post-enhanced community quarantine period among PGH medical staff (consultants, residents, fellows). Methods: The cross-sectional study was conducted from October 2020 to July 2021. Medical staff from the 16 clinical departments of the PGH were selected by systematic random sampling. Inclusion criteria included appointment as medical staff in PGH or University of the Philippines College of Medicine (UPCM), voluntary informed consent, internet access, and technical capacity to access e-mail and SurveyMonkey™. The online survey consisted of two questionnaires. It collected data on the demographic profile and outcomes of interest (e.g., telemedicine readiness and acceptance). Technological readiness was determined through the 16-item modified version of Technological Readiness Index (TRI) version 2.0, while telemedicine acceptance was determined through the modified version of the 19-item Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire. Descriptive and analytical statistics were performed at a 95% confidence interval. Results: The study had an 87% response rate with 205 respondents, 62% of whom were physicians in training (resident physicians and fellows). The respondents had a median age of 33 years and were mostly males. Only 19% had telemedicine experience before the pandemic. The majority (51%) learned telemedicine on their own. The most common devices used for telemedicine were mobile or smartphones (53%) and laptops (38%). The primary source of internet for telemedicine was mobile broadband (e.g., cellular data) (40%). The majority practiced telemedicine at their home or residence (51%), followed closely by the hospital or clinic (47%). The mean score of the respondents on TRI was 3.56 (very good technological readiness), and 4.00 (very good telemedicine acceptance) on UTAUT (behavioral intention to use the system). Performance expectancy (p = 0.02), effort expectancy (p = 0.03), and self-efficacy (p = 0.02) were significantly directly related to telemedicine adoption, while anxiety (p = 0.03) was significantly inversely related. Conclusion The PGH medical staff were found to have very good telemedicine readiness and acceptance. This suggests a willingness to use telemedicine during the pandemic. Further studies on the organization and technical support system of the telemedicine program in the PGH are strongly recommended. The quality and efficiency of the program will strongly influence the continued use of telemedicine by the medical staff even after the pandemic.
Health Services Administration ; Telemedicine ; Telecommunications ; Remote Consultation ; COVID-19

Telemedicine is described as combination of topics from the fields of telecommunication, medicine, and information and literally telemedicine means medicine at a distance. In this study, we present a web based real-time telemedicine application(WEBRETA) that was designed for patients who needs diagnosis on the Internet. The WEBRETA system is supporting transmitting of MPEG-4 video format(640*480)that was appropriate for Internet and designed with ActiveX controls technology that is also suitable for telecommunication link such as ADSL, VDSL and Cable modem which are very popular communication link in Korea. To improve the reliability and the usefulness of this prototype we involved the PSNR method and subjective score measuring from doctors. Futhermore, we will evaluate the WEBRETA with various communication network environment to improve how this system can contribute the diagnosis of patients and to analysis.
Diagnosis ; Humans ; Internet ; Korea ; Modems ; Telecommunications ; Telemedicine*

We developed the Tele-PACS of radiology, which uses the communication network as asymmetric satellite data communication system. The asymmetric satellite data communication system uses receive-only satellite links for data delivery and PSTN(Public Switched Telephone Network) modem or N-ISDN(Narrow-band Integrate Services Digital Network) for communication. The satellite communication linking we implemented showed the very high-speed performance compared to the terrestrial linking such as 28.8 kbps modem linking or 56Kbps linking. The satellite linking was 5-10 times faster than the terrestrial linking on the average. We developed the down-link system of satellite and the medical collaborative tools and the Web-based Image-viewer. We concluded that 1) Satellite networking is currently the cheapest and fastest solution for internet access. 2) Web-based Image-Viewer enables small size hospitals in rural area to connect to the central PACS easily and to retrieve the image data reliably. 3) The suggested teleradiology system using satellite networking could be adequate to the fast telemedicine and telecare for rural hospitals especially located in geographically isolated areas such as islands.
Hospitals, Rural ; Internet ; Islands ; Modems ; Satellite Communications ; Telemedicine ; Telephone ; Teleradiology

We developed the Tele-PACS of radiology, which uses the communication network as asymmetric satellite data communication system. The asymmetric satellite data communication system uses receive-only satellite links for data delivery and PSTN(Public Switched Telephone Network) modem or N-ISDN(Narrow-band Integrate Services Digital Network) for communication. The satellite communication linking we implemented showed the very high-speed performance compared to the terrestrial linking such as 28.8 kbps modem linking or 56Kbps linking. The satellite linking was 5-10 times faster than the terrestrial linking on the average. We developed the down-link system of satellite and the medical collaborative tools and the Web-based Image-viewer. We concluded that 1) Satellite networking is currently the cheapest and fastest solution for internet access. 2) Web-based Image-Viewer enables small size hospitals in rural area to connect to the central PACS easily and to retrieve the image data reliably. 3) The suggested teleradiology system using satellite networking could be adequate to the fast telemedicine and telecare for rural hospitals especially located in geographically isolated areas such as islands.
Hospitals, Rural ; Internet ; Islands ; Modems ; Satellite Communications ; Telemedicine ; Telephone ; Teleradiology

OBJECTIVES: Through telehealth, medical services have expanded beyond spatial boundaries and are now available in living spaces outside of hospitals. It can also contribute to patient medical knowledge improvement because patients can access their hospital records and data from home. However, concepts of telehealth are rather vague in Korea. METHODS: We refer to several clinical reports to determine the current clinical status of and obstacles to telehealth in Korea. RESULTS: Patients' health conditions are now reported regularly to doctors remotely, and patients can receive varied assistance. Self-improvement based on minute details that are beyond medical staff's reach is another possible benefit that may be realized with the help of a variety of medical equipment (sensors). The feasibility, clinical effect, and cost-benefit of telehealth have been verified by scientific evidence. CONCLUSIONS: Patients will be able to improve their treatment adherence by receiving help from various professionals, such as doctors, nurses, nutritionists, and sports therapists. This means that the actual treatment time per patient will increase as well. Ultimately, this will increase the quality of patients' self-administration of care to impede disease progression and prevent complications.
Disease Progression ; Hospital Records ; Humans ; Korea* ; Nutritionists ; Remote Consultation ; Sports ; Telecommunications ; Telemedicine*

OBJECTIVES: An official guideline must be prepared for legalizing the doctor-patient telemedicine system based on the evaluations of the ongoing telemedicine demonstration project performed by the Korean government. In this study, critical items of the Korean telemedicine guideline are suggested based on the guidelines of developed countries. METHODS: To investigate the telemedicine guidelines of developed countries, a keyword of 'telemedicine guidelines' was used for Google search to find out US, Australian, and Japanese guidelines. The common items included in two or more of the followings were screened: US Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interactions, the Australian New South Wales (NSW) Agency for Clinical Innovation Guidelines for the use of Telehealth for Clinical and Non Clinical Settings in NSW, and the Japanese Guidelines for the practice of home telemedicine. RESULTS: A total of 22 common items of the following four domains, which could be used for the Korean guideline were screened: the common features in overall considerations (6 items), the common features in clinical considerations (6 items), the common features in technical considerations (5 items), and the common features in privacy considerations (5 items). These 22 items were suggested as the critical items of the Korean telemedicine guideline. CONCLUSIONS: The screened 22 items of the telemedicine guideline must be further organized for details. Additional studies and professional opinions on the telemedicine cases and on the guidelines of developed countries are required to establish the Korean guideline in the near future.
Asian Continental Ancestry Group ; Developed Countries ; Health Care Reform ; Humans ; Korea* ; New South Wales ; Privacy ; Remote Consultation ; Telecommunications ; Telemedicine*

OBJECTIVES: Healthcare is now routinely delivered by telecommunications-based services in all developed countries and an increasing number of developing countries. Telemedicine is used in many clinical specialities and across numerous healthcare settings, which range from mobile patient-centric applications to complex interactions amongst clinicians in tertiary referral hospital settings. This paper discusses some recent areas of significant development and progress in the field with the purpose of identifying strong trends in both research and practice activities. METHODS: To establish the breadth of new ideas and directions in the field, a review of literature was made by searching PubMed for recent publications including terms (telemedicine OR telehealth) AND (challenge OR direction OR innovation OR new OR novel OR trend), for all searchable categories. 3,433 publications were identified that have appeared since January 1, 2005 (2,172 of these since January 1, 2010), based on a search conducted on June 1, 2015. RESULTS: The current interest areas in these papers span both synchronous telemedicine, including intensive care, emergency medicine, and mental health, and asynchronous telemedicine, including wound and burns care, dermatology and ophthalmology. CONCLUSIONS: It is concluded that two major drivers of contemporary tele medicine development are a high volume demand for a particular clinical service, and/or a high criticality of need for clinical exper tise to deliver the service. These areas offer promise for further study and enhancement of applicable telemedicine methods and have the potential for large-scale deployments internationally, which would contribute significantly to the advancement of healthcare.
Burns ; Critical Care ; Delivery of Health Care ; Dermatology ; Developed Countries ; Developing Countries ; Emergency Medicine ; Mental Health ; Ophthalmology ; Remote Consultation ; Telecommunications ; Telemedicine* ; Tertiary Care Centers ; Wounds and Injuries

BACKGROUND/AIMS: Telemedicine is a useful tool for remote education to overcome limitations of location. We have shared medical knowledge by the use of a real-time, high quality digital video transfer system (DVTS). The study aim was to evaluate the use of the DVTS by viewer questionnaire. METHODS: After an endoscopic live demonstration using DVTS and satellite broadcasting system (SBS), questions were provided for the degree of satisfaction about image and sound of the presentation. A questionnaire was composed of 11 questions concerning factors such as a comparison of image quality between the two systems. The preference between DVTS with SBS was analyzed. RESULTS: For image quality, SBS was more preferable than DVTS (65.6% versus 16.7%). However, 16.7% found no difference between the use of DVTS and SBS. For the time delay between the image and sound, 62.5% preferred SBS and 11.5% preferred DVTS. The satisfaction for combining DVTS with SBS were 68% as good and 22% as very good. CONCLUSIONS: We have demonstrated the feasibility of telemedicine by the demonstration of a satisfactory teleconference, although DVTS was utilized as an assistant tool. DVTS should prove to be a promising tool as a useful and economic means to provide remote medicine.
Education, Medical ; Telecommunications ; Telemedicine ; Surveys and Questionnaires

Telemetering is one of the ideal methods of metering biomedical signal. This paper emphasizes remote medical treatment system and its exploitation, realization and application. It gives an overview of the recent development of biotelemetry. At the same time, it discusses the principle, realization, new development of other biotelemetry methods and further research tendencies on biotelemetry as well.
Biotechnology ; Electrocardiography, Ambulatory ; instrumentation ; Humans ; Internet ; Monitoring, Physiologic ; instrumentation ; Signal Processing, Computer-Assisted ; instrumentation ; Telecommunications ; instrumentation ; Telemedicine ; Telemetry ; instrumentation ; trends

PURPOSE: Seafarers injured at sea need appropriate and prompt medical advice. Since 2002, the Busan emergency medical information center (BEMIC) has provided remote medical advice to vessels on the distant ocean via telephone, e-mail, facsimile and radio-transmission. METHODS: Seventy-four cases had requested remote medical advices to BEMIC from Jan 2005 to Jul 2005, and they were studied retrospectively. We analyzed patients' general characteristics, type of disease or injury, dispositions, and so forth. The cases were classified into three groups according to disposition. Class I was defined as a case which required simple treatment. Class II involved medical or surgical treatment with close observation. Class III required transfer to the nearest harbor instantly due to severe or uncertain condition. RESULTS:The nationalities of subjects were Korean (32.4%), Southeast Asians (35.1%), Chinese (24.3%) and others. The most common symptom was abdominal pain (24.3%). The patients'disease types were acute disease (53.4%), trauma (20.3%), burn (13.7%), chronic disease (8.2%) and others. There were 8 voluntary medication cases, which were performed by seamen before taking medical advice. The dispositions were class I (6.8%), class II (39.7%), and class III (53.5%), respectively. A cross-sectional study between the types and the dispositions was performed, revealing a statistical significance (p<0.001). CONCLUSION: Despite the lack of any kind of direct support from ship companies or governments, the remote medical advice service has performed. Enhancing educational programs based on this data is necessary in order to provide effective education of seafarers.
Abdominal Pain ; Acute Disease ; Asian Continental Ancestry Group ; Burns ; Busan ; Chronic Disease ; Cross-Sectional Studies ; Education ; Electronic Mail ; Emergencies* ; Ethnic Groups ; Humans ; Information Centers* ; Korea* ; Remote Consultation ; Retrospective Studies ; Ships ; Telemedicine ; Telephone