Telemedical record documentation: a preliminary survey.

Telemedical records are the weak link in telemedicine. With a number of medicolegal and reimbursement issues still unresolved, telemedical record documentation will be a critical piece of the puzzle when the patient's original legal medical record must be produced. A questionnaire was distributed to active telemedicine programmes in the USA to determine how interactive teleconsultations were being documented. Forty programmes completed the questionnaire. The responses indicated a lack of consistency and a need for documentation guidelines for telemedical records.

Telemedical record documentation.

Telemedicine is rapidly evolving into a viable method of delivering health care. As programs become more active, healthcare organizations must examine policies and procedures to assure they meet the needs of the changing complexities of healthcare delivery. Telemedicine, or providing health care from a distance, brings with it a new dimension that complicates a number of unresolved issues. Reimbursement and telemedicolegal concerns particularly bring into focus the need for quality documentation for telemedicine. A proposed telemedical record model provides guidelines to ensure consistent, accurate, timely, and nonduplicative documentation of teleconsultations in any telehealth scenario.

Use of video in the informed consent process.

We created a video-tape about the concept of telemedicine for informational and educational purposes. Two video-tapes, one with and one without the informed consent segment, were distributed to each of the Kentucky TeleCare sites. On the day of their teleconsultation, patients were asked to watch the video-tape (with the version containing the informed consent segment) before signing the informed consent to participate. Site coordinators then asked patients whether they had any specific questions about telemedicine. To date, patients have reported high levels of satisfaction with this method of consultation, using telecommunications technology to deliver health care.

Security in the management of information systems.

Although security technology exists in abundance in health information management systems, the implementation of that technology is often lacking. This lack of implementation can be heavily affected by the attitudes and perceptions of users and management, the "people part" of systems. Particular operational, organizational, and economic factors must be addressed along with employment of security objectives and accountability. Unique threats, as well as controls, pervade the use of microcomputer-based systems as these systems permeate health care information management.

A telemedical record model.

Medical record issues appear to be the weak link in telemedicine. A telemedical record model is proposed which would fit both a managed-care and fee-for-service health-care environment. In this model, the originator of the teleconsultation referral is the party responsible for creation of the record, since that is the initial point of patient contact. The telemedical record model prevents duplication of information gathering and provides a consistent way to document teleconsultations. Telemedical record policies and procedures should be in place before starting a telemedicine programme, to ensure consistency in the documentation of doctor-patient encounters.

Patient satisfaction with multispecialty interactive teleconsultations.

Satisfaction with teleconsulting was evaluated for 96 patients using the Kentucky TeleCare telemedicine network. Consultant specialties included psychiatry (41), dermatology (24), clinical nutrition (20), anaesthesia (3), infectious diseases (3), rheumatology (2), internal medicine (1), neurology (1) and paediatric pulmonology (1). The results indicated a high level of patient satisfaction, with a mean score of 6.8 (on a 7-point Likert scale with 1 = strongly disagree and 7 = strongly agree) for the question 'Overall, I was very satisfied with today's consultation'. The results indicated that the majority of patients were satisfied with the telemedicine encounter although a minority, 16%, would have preferred to have seen the specialist in person.

How learning style and personality type can affect performance.

Many factors can influence the performance of allied health professionals in the academic arena and working environment. This study looked at how learning style and personality type influenced the performance of medical transcription students in both routine and creative tasks. Since the sample was small, there were no statistically significant findings, but an interesting pattern did emerge. Further study is warranted to determine how to fit health care professionals to the jobs for which they are best suited.

How to break down tasks so they don't break you: coping with overwhelming demands on your time.

Everyone, in every profession, seems to have too much to do and too little time to do it all. This seems to be even more true in the health care setting, where change is constant. Health care supervisors can become so overwhelmed with tasks that are expected of them that they have no idea of where to even begin. Rather than thinking about everything that must be done, the one single task strategy describes how you can break down your overwhelming tasks into manageable steps.

The effects of computer monitoring on the medical transcriptionist's performance and stress.

This study serves to evaluate the effects of computer monitoring on the performance of medical transcriptionists. The results of the study show that performance increases in the monitored state but that perceived levels of stress decrease in the monitored state. Previous studies are discussed in light of health information managers' use of monitoring technology to increase the effectiveness of medical transcriptionists.

Maximize learning through wellness.

By achieving wellness to some degree in all five components of health, the self-concept of the health care employee can be raised. If the worker begins with physical health, this can in turn affect the emotional, mental, social, and spiritual health of the individual. All of these elements of well-being have been shown to have a profound effect on learning abilities and performance levels of the adult. Health care professionals are dealing with life or death decisions on a daily basis. Hopefully, everyone would agree that the health care team should be performing at its peak ability. To do this, each member of the health care team should strive for wellness. The health care facility should promote wellness for its employees first, so they in turn can deliver quality health care services. Keeping current with the constant changes in the health care industry and learning new information is a critical part of that delivery of quality care.

Wellness: ten ways to make your workplace healthier.

These 10 suggestions to make the workplace healthier are just a few ideas to get a health promotion or wellness program started. Employees are a great resource for ideas and suggestions, and unless the health care supervisor asks, the needs of the worker may remain unfulfilled. If a health care facility decides to initiate such a program, it will find that everyone will win. The employees will feel cared about and will, in return, care more about their jobs and responsibilities. Health care team members should be promoting health, not only for patients, but for themselves and their employees as well. In 1974, then Governor of North Carolina Terry Sanford said: "We need to invent and present more alternative approaches to health care, principally in teaching people how to care better for themselves, and the more difficult challenge--convincing them that they should." Institutions can start with their own health care employees, by making it easier for them to take better care of themselves.

Effect of treatment protocol and sample time on the frequencies of micronucleated polychromatic erythrocytes in mouse bone marrow and peripheral blood.

Studies were conducted to evaluate the effect of experimental protocol on the ability of benzidine (BZD), dimethylbenzanthracene (DMBA) and mitomycin C (MMC), administered by intraperitoneal injection, to induce micronuclei in polychromatic erythrocytes (PCE) of B6C3F1 mice. Three different treatment/sampling protocols were used, involving from one to three consecutive daily treatments and from three to one, respectively, consecutive daily samplings beginning 24 h after the last injection. DMBA and MMC elicited a significant micronucleus response in all three experimental protocols, while BZD induced a significant response only in the multiple injection protocols. Of the three protocols, the 3-day injection/single sample time protocol offers the greatest efficiency in minimizing the number of animals required in a study, in decreasing the time needed for scoring and in simplifying the statistical analysis. In addition, a comparison of the frequency of micronucleated PCE in peripheral blood and bone marrow following the treatment of mice with either BZD or DMBA suggests that, following a three injection protocol, either tissue can be used with equal efficacy.