Strategic Procedures and Revisions for implementing Telemedicine and Telecare in Greece.

The development of telemedicine and telecare has been changed all over the world the recent decades as practitioners and health care managers reached better understanding of the use of information and communication technologies to offer urgent and qualified medical services at a distance. Governments and health care providers have shown a large initial interest in the benefits of telemedicine services to reduce costs mostly for patient's transfer to tertiary hospitals or for educational purposes but have been slow to provide strategic plans and procedures in order to proceed the projects into practice. The paper identifies the involvement of governments, healthcare management, healthcare professionals and IT suppliers in telemedicine policy development and reviews the experience of Greece in the specific field which seems that despite the enormous scientific interest for both medicine and health informatics, the practice until now has not gained the expected results. Furthermore, the analysis concerns the critical success factors that have to be revised simultaneously with the main managerial principles for the design and implementation of quality telemedicine and telecare services.

Cervical intraepithelial dysplasia (CIN 3) and history of herpes genitalis (HSV2) in women living in Attica, Greece.

This article presents a study on women living in Attica, Greece (an area of 4.5 million inhabitants) who visited the outpatient clinics of two specialized hospitals for a follow-up for cervical intraepithelial neoplasia (CIN 3). A random sample of 170 women with CIN 3 and a control group of 195 women coming from the general population were interviewed. A semi-structured designed questionnaire was used as an instrument for data collection. The aim of the study was to search for a possible correlation between CIN 3 and a past history of herpes genitalis (HSV2) of the women and/or their partners. According to the results, CIN 3 is more frequent among women between 26 and 40 years of age. The majority of the patients (70.3%) reported a past history of HSV2, but only 10.9% of the subjects in the control group had the same medical history (p = 0.000). Sixteen percent of the patients and only 5.3% of the subjects in the control group reported infection of their sexual partners with HSV2. 75 patients (44.6%) stated that they did not know if their sexual partners had a past history of HSV2, while only 27 women (13.3%) in the control group reported the same (p = 0.000). Patients reported more sexual partners than women in the control group.

A prototype design of cardiological computerized nursing care plans for an electronic patient care record.

The purpose of this paper is to describe the design and the process of Cardiological Nursing Care Plans proposed to be used within an electronic patient record that can fulfill both nursing science and experience. The project is focused on the development of a clinical database capable of analysis to link control of nursing process with clinical outcome.

Supervision of thrombolysis of acute myocardial infarction using telemedicine.

The treatment of acute myocardial infarction (MI) constitutes a significant problem in remote geographical areas of Greece. Furthermore, thrombolysis, the treatment of choice in the early phase of acute MI, requires the supervision of an expert. We have used thrombolytic treatment, using telemedicine, in remote medical centres. The Onassis Cardiac Surgery Centre was linked to six remote Aegean islands via telemedicine systems which permitted the transmission of 12-lead electrocardiograms (ECGs). The thrombolytic agent anistreplase was administered to patients with acute MI. Supervision, including consultation for treatment of complications, was achieved using the telemedicine system. One hundred and fifty-two ECGs were transmitted during 24 months, of which 108 (71%) indicated specific treatment of a cardiac condition. Ten cases were diagnosed as having acute MI and eight of these were treated with anistreplase. All patients survived acute MI and complications were treated locally. The application of thrombolytic treatment in acute MI is feasible in remote areas, with the use of a telemedicine system.

Urgent response telecardiology services and training--collaboration between Onassis Cardiac Surgery Hospital and Aegian Islands' Health Care Centers.

Since 1995, Onassis Cardiac Surgery Center participates in the development of Telecardiology Services in Greece. Existing connections include the islands Skiathos, Naxos, Santorini, Mykonos, Milos, Plomari and Amorgos. First hundred fifty three (153) cases have been already analysed. Eleven of them were acute myocardial infarctions and have been treated by thrombolytic medication (anistreplase). The participation of physicians and nurses was valuable for the success of the program and their further involvement in the new area of Telemedicine. The purpose of the project was to offer high quality cardiac services in remote area patients and to provide specific training in telemedicine issues to health care professionals.

Integration of a hospital information system in a Greek cardiac surgery hospital through specific education programs for health care personnel: development of nursing documentation.

This study represents an educative effort for integrating an innovative Hospital Information System (HIS) in Greece for quality impact on nursing practice and conductive research. The Hospital involved is the Onassis Cardiac Surgery Center (OCSC), a new 150 bedded state-of-the-art hospital in Athens. The aims of this study are the following: 1) To present the educational assessment concerning the HIS of Onassis Center, 2) To develop Nursing documentation to support the educational needs of nurses and clerks in correlation with the Nursing/Medical record of HIS, and 3) To show the meaning of continuing education for new and old hospital staff and the use of the system as an educative and consultative tool for decision support for health care personnel, especially nurses.