Journal of the International Society for Telemedicine and eHealth 2018-12-06T10:56:15South Africa Standard Time Maurice Mars Open Journal Systems <p>The Journal of the International&nbsp; Society for Telemedicine and eHealth (<strong>JISfTeH</strong>) is an official journal of the International Society for Telemedicine and eHealth whose stated mission is to "Facilitate the international dissemination of knowledge and experience in <strong>Telemedicine</strong> and <strong>eHealth</strong> and provide access to recognised experts in the field worldwide." <strong>JISfTeH</strong> is a peer reviewed, open access, online journal that seeks to publish information on all aspects of eHealth activity and research from around the World. Its primary focus is on original research, critical reviews, preliminary communications and case reports. Scientific letters and letters to the editor are also welcomed. <strong>JISfTeH</strong> encourages&nbsp; submission of&nbsp; preliminary communications and short reports from developing countries. Papers are published online immediately on acceptance of the final galley proofs to ensure rapid access to new work.</p> <p><strong>Editors-in-Chief:</strong> Prof. Maurice Mars, and Prof. Richard E. Scott</p> <p><strong>Online ISSN:</strong>&nbsp;2308-0310</p> Consent: A Luta Continua 2018-12-01T11:29:24South Africa Standard Time Maurice Mars Richard E Scott 2018-04-03T15:21:08South Africa Standard Time ##submission.copyrightStatement## Speech-language Pathology Services Delivered by Telehealth in a Rural Educational Setting: the School’s Perspective 2018-12-06T10:56:15South Africa Standard Time Natalie K Bradford Liam J Caffery Monica Taylor Judith Meiklejohn Anthony Smith C C Smith Danette Langbecker <p><strong>Introduction:</strong> Access to speech-language pathology services for children in rural and remote communities is often limited. Telehealth is increasingly used to provide these services to schools, demonstrating high satisfaction with both service providers and recipients, but the requirements for successful program implementation are as yet unclear. We aimed to explore the implementation requirements for a telehealth speech-language pathology service for children from the perspective of a rural school. <strong>Methods</strong>: A qualitative approach, supplemented by program activity data, was used to understand the experiences and perceptions of the benefits, limitations, enablers and barriers of a telehealth speech-language pathology program delivered to a school servicing approximately 400 children in a small rural town in the state of Queensland, Australia. Thematic analysis was conducted of transcripts of individual semi-structured interviews with nine school teaching staff and field notes of informal discussions regarding 85 speech-language pathology telehealth sessions (n = 9 children) during program establishment and implementation. <strong>Results</strong>: The speech-language pathology telehealth service was acceptable to teaching staff at the rural school, who cited improved access, the suitability of the technology for child engagement, and perceived effectiveness. Implementation issues were highlighted as critical to program success and scalability, particularly staff workload, technological issues, communication processes, and sustainability. <strong>Conclusion</strong>: School-based speech-language pathology services delivered via telehealth were perceived as a suitable way of increasing access for children by rural school staff. Future implementations of telehealth speech-language pathology programs should prospectively consider workload implications and develop strategies to communicate with and involve school staff.</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> 2018-12-06T10:56:10South Africa Standard Time ##submission.copyrightStatement## Tele Speech-Language Pathology and Audiology in India - A Short Report 2018-12-01T11:34:12South Africa Standard Time Yashaswini - Rangaswamy Prema K.S. Rao <p><strong>Background:</strong> The discipline of Speech-Language Pathology and Audiology is half-a-century old in India. Speech language pathologists and audiologists (SLPs and AUDs) have identified the need to ‘reach-the-unreached’ in India by using a telehealth model for rehabilitation of persons with communication disorders. The aim of this paper is to present a panoramic view of telepractice in India right from its emergence to its current state, drawing support from a review of published work by SLPs and AUDs in India. <strong>Methods:</strong> A questionnaire was developed to elicit responses on barriers for telepractice and similarities and differences in face-to-face and telepractice of speech-language pathology service delivery. Using survey research design, 17 speech-language pathologists practicing in India were purposively selected for the study. <strong>Results</strong>: 15 questionnaires were completed. Most respondents (53.3% - 86.6%) reported technical issues as barriers for telepractice. Face-to-face and telepractice of speech language pathology service delivery was reported to be different in terms of instructions for caregivers, documentation, face validity, acceptance and responsibility on caregivers. Many participants felt that more sensitivity and caution, special ICT skills for clinician and caregiver/client, exclusive software, dedicated professionals to trouble shoot technical issues are additional requirements for telepractice. Concerns about client confidentiality were expressed and lack of direct feedback and environmental distractions at client end were reported as challenges in telepractice delivery. <strong>Conclusions: </strong>The study demonstrates that service delivery through telemodel is mostly positively embraced in India, despite the challenges.</p> <p>&nbsp;</p> <p>&nbsp;</p> 2018-11-11T07:25:07South Africa Standard Time ##submission.copyrightStatement## Using Mobile Videoconferencing to Deliver Simultaneous Multi-Centre Health Education to Elderly People: A Pilot Study on Acceptance and Satisfaction 2018-12-01T11:36:38South Africa Standard Time Kup-Sze Choi Hon-Fat Wong <div><strong>Background: </strong>Improving the health literacy of elderly people is an important means of promoting preventive care by empowering self-health management. While talks and workshops are common ways of delivering health education, their scale and coverage are limited by practical constraints. In this regard, a mobile multi-centre videoconferencing (VC) approach is proposed to connect elderly people at different elderly care centres, so that healthcare promotion activities conducted at one centre can be multicast simultaneously to others. The aim of this pilot study is to evaluate the acceptance and satisfaction of users with this approach. <strong>Methods: </strong>Three VC sessions were conducted to evaluate users’ acceptance and satisfaction of the proposed approach in different settings from a technical perspective. Healthcare promotion activities concerning healthy diets and health-promoting exercises were delivered using a commercial videoconferencing system and a cellular 4G network. User acceptance and satisfaction were measured at the end of each session using a 10-item 5-point Likert questionnaire, with 5 indicating the most positive response. <strong>Results: </strong>A total of 96 participants aged 60 years or above were recruited, with 12, 30, and 54 participants taking part in the three sessions, respectively. The mean scores of the items for the three sessions were within the ranges of 4.3–4.8, 4.4–4.8, and 3.7–4.5, respectively. <strong>Conclusion </strong>The results show that the multi-centre videoconferencing approach was accepted by the participants from a technical perspective. It is potentially a feasible approach for promoting health literacy to elderly people.</div> 2018-10-30T09:54:44South Africa Standard Time ##submission.copyrightStatement## The Feasibility and Satisfaction of Using Telemedicine to Provide Tertiary Paediatric Obesity Care 2018-12-01T11:38:54South Africa Standard Time Reza Sadeghian Rebecca Ann Gooch Leigh Ann Phelps Daniel Preud'homme <p>Although telemedicine in paediatric tertiary care has been tried, satisfaction and outcome data is limited due to small sample sizes and the variation of methods and personnel by which telemedicine technology is delivered and participants assessed. <strong>Aim: </strong>to determine the feasibility of using telemedicine to deliver Paediatric tertiary obesity care and to evaluate Patient/Physician/Staff satisfaction. <strong>Method</strong>: we used a commercially available telemedicine system to conduct a prospective study where 30 patients in a Paediatric Healthy Life Centre Outpatient Clinic were evaluated by a specialist physician using telemedicine technology. A qualitative assessment of the patient/physician/staff perceptions of telemedicine use was assessed through a five-point Likert Scale and free text answers. <strong>Results: </strong>of the 30 patient sessions, 27 (90%) consultations were performed to completion. Fifteen consultations were initial assessments. Physician, staff and patient responders agreed that the use of telemedicine is an appropriate and effective use of the clinician’s skillset and time (≥96%), and can avoid patient travel from an underserved area to a tertiary care clinic (≥95%). Responders were comfortable and satisfied using the telemedicine equipment (≥85%). Physician and patients agreed that the telemedicine equipment helped the patient avoid a face-to-face visit (≥90%). Physician and patients felt the technology was effective in the management of their visit (≥93%). <strong>Conclusions: </strong>we successfully delivered tertiary obesity care through the use of telemedicine equipment in different clinical situations associated with paediatric obesity. Telemedicine is feasible, and is a realistic, successful and cost-effective modality to provide well-received specialty care for the obese paediatric population.</p> 2018-09-18T00:00:00South Africa Standard Time ##submission.copyrightStatement## Experience and Perspectives of Remote Interactive Training in Medicine 2018-12-01T11:41:30South Africa Standard Time Valeriy Stolyar Elena Lukianova Maya Amcheslavskaya Ekaterina Shimkevich Tatiana Lyapunova <p>Over the past 20 years there has been growing interest in remote interactive training of doctors using videoconferencing that allows for the exchange of knowledge and experience, and facilitates the introduction of new technologies. Videoconferencing was initially constrained by digital communication limitations and costs, but modern videoconferencing tools have helped to resolve this. Access to the experience and knowledge of leading world specialists can achieve through interactive video lectures, master classes or participation in scientific conferences. A Telemedicine Centre for videoconferencing based on modern ITU standards and a simulation-training centre where physicians can improve their practical skills have been installed at the Medical Institute of the RUDN- University. This provides the necessary infrastructure and conditions for the provision of videoconference based continuing medical education (CME) programmes which allow &nbsp;physicians to study at their workplace Two professional educational programmes on telemedicine have been developed and have been included in the list of CME programmes approved by the Ministry of Health of Russia. Using videoconferencing for interactive distance learning in CME, allows. These consist of theoretical sections of telelectures with interactive remote master classes from leading Russian and foreign clinics, the provision of parallel work using medical simulators, as well as the introduction of 3D visualization technologies in organizing master classes will improve practical skills.</p> 2018-09-15T00:00:00South Africa Standard Time ##submission.copyrightStatement## Motion Capture for Telemedicine: A Review of Nintendo Wii, Microsoft Kinect, and PlayStation Move 2018-12-01T11:43:21South Africa Standard Time Anthony R Khoury <p>Access to healthcare has been and continues to be difficult for many around the world. With the introduction of telemedicine, this impediment to attaining medical care has been lifted. Although many avenues of telemedicine exist (and have yet to exist), the use of home video game consoles such as the Nintendo Wii<sup>®</sup>, Microsoft Kinect<sup>®</sup>, and PlayStation Move<sup>®</sup> can be used to measure patient progress outside of the office. Due to the nature of each individual console/system, some unique characteristics exist that allow each system to provide its own clinical potential. A comparative analysis of the clinical implications of the Nintendo Wii<sup>®</sup>, Microsoft Kinect<sup>®</sup>, and PlayStation Move<sup>®</sup> showed that with its ease of use and dynamic accuracy, the Microsoft Kinect<sup>® </sup>offered the most benefit. With further exploration, using the Microsoft Kinect<sup>®</sup> for telemedicine will be able to improve medical efficiency and hopefully health outcomes.</p> 2018-09-15T00:00:00South Africa Standard Time ##submission.copyrightStatement## Logistics and Uptake of Genetic Testing for Patients Referred for Telegenetic Counselling for Cancer 2018-12-01T11:45:50South Africa Standard Time Kate Parks Shane-Carson Cortlandt Martin <p><strong>Purpose:&nbsp; There is a dearth of information about the uptake of genetic testing after telegenetic (videoconference) counselling for hereditary cancer, which has been previously reported as a limitation of this service delivery model.&nbsp; Methods:&nbsp; We performed a review of the triage list for patients referred to The Ohio State University (OSU) from two community cancer centres for telegenetic counselling appointments from April 1, 2014 to May 31, 2016.&nbsp; Results:&nbsp; A total of 179 patients were referred for telegenetic counselling, and of&nbsp;&nbsp; these 62.6% (112/179) completed a 30-60 minute telegenetic counselling appointment.&nbsp;&nbsp; Of those counselled, 82.1% (92/112) completed genetic testing,&nbsp;&nbsp;&nbsp; 12.0% (11/92) of whom were found to have a pathogenic mutation.&nbsp; Of those with mutations, 45.5% (5/11) returned for a follow-up telegenetic counselling session to review results in more detail.&nbsp; In addition, 18.5% (17/92) of patients tested had at least one variant of uncertain significance (VUS). Conclusions:&nbsp; The presence of a nurse/nurse practitioner with the patient at the remote site during the telegenetic counselling session may have facilitated higher completion rates for genetic testing compared to previous reports in the literature, and appropriateness of genetic testing in this method of providing genetic counselling is reflected in the rates of results identifying deleterious mutations and variants of uncertain significance. </strong></p> 2018-05-28T11:54:21South Africa Standard Time ##submission.copyrightStatement## Modern Approach to the Study of Telemedicine Technologies in the Medical Institute 2018-12-01T11:50:22South Africa Standard Time Valery Stolyar Elena Lukianova Maya Amcheslavskaya Tatiana Lyapunova Ekaterina Shimkevich Vladimir Protsenko <p><strong>Telemedicine is being actively introduced into medical practice, however, in order for it to become an effective tool in their hands, a basic knowledge of the possibilities and limitations of modern telemedicine technologies is needed, as well as practical skills in the preparation and conduct of videoconferencing. This led to the need to include a course on the basics of telemedicine technology in the training of medical personnel. The Department of Medical Informatics created the educational module "Telemedicine", which is implemented by the Telemedicine Centre of the Medical Institute of the Peoples' Friendship University of Russia. After theoretical lectures, students receive practical skills through business games and conducting videoconferencing. Classes are conducted in accordance with world trends and standards. During the classes we demonstrate to students the technologies of remote interactive learning, in particular television lectures and master classes from the leading clinics of Russia, countries of Europe, India, Brazil and Canada. This practice allows our graduates to maintain contact with their teachers through telemedicine opportunities and participate in videoconferenced postgraduate education with PFUR professors, and international conferences held at PFUR sites. The experience of teaching the senior students of the PFUR Medical Institute is presented.</strong></p> 2018-05-17T15:02:18South Africa Standard Time ##submission.copyrightStatement## Satisfaction With In-Home Speech Telerehabilitation in Post-Stroke Aphasia: an Exploratory Analysis 2018-12-01T11:52:17South Africa Standard Time Michel Tousignant Joel Macoir Vincent Martel-Sauvageau Patrick Boissy Hélène Corriveau Suzanne Gosselin Marie-France Dubois Marilyn Tousignant Catherine Pagé <p><strong>Patient satisfaction with healthcare has a major impact on clinical outcomes and compliance. Satisfaction with telehealth services for speech and language problems has been documented but not in post-stroke aphasia. The main objective here was to evaluate patient satisfaction with speech tele rehabilitation</strong> <strong>based on the PACE pragmatic rehabilitation approach in post-stroke aphasia. </strong><strong>This study was embedded in a pre-/post-test feasibility and efficacy study in which 20 patients with chronic post-stroke aphasia received 3 weeks of speech therapy (9 sessions) through in-home tele-rehabilitation. A telerehabilitation platform based on a commercial videoconferencing system (Tandberg 550 MXP) with custom software was used to transmit audio, video and data through a high-speed Internet connection between the participant’s home and the clinician. Participants’ satisfaction with in-home telerehabilitation and healthcare received was assessed using French adaptations of the Telemedicine Satisfaction Questionnaire and Health Care Satisfaction Questionnaire. Satisfaction with functional communication, i.e. communication in common situations of daily life, was compared pre- and post-intervention with participants and caregivers. Participants’ satisfaction with in-home telerehabilitation was excellent (94%±4.3%). Satisfaction with healthcare received was good overall (80%±11.4%) and for three factors measured independently, i.e. relationship with healthcare professional (84%±12.5%), services delivered (73%±13.8%), and general healthcare&nbsp; organization (84%±12.0%). Participants’ and caregivers’ satisfaction with communication was higher after the intervention (p=0.001 and p&lt;0.001, respectively) and was correlated with age (r=-0.60; p=0.007). Patients with post-stroke aphasia receiving speech tele-therapy were very satisfied with this service delivery method. Also, technology use was not an issue for seniors post-stroke. </strong></p> 2018-05-18T10:58:09South Africa Standard Time ##submission.copyrightStatement## How to Prevent Technical Issues in Large Multiparty Medical Videoconferencing 2018-12-01T11:54:30South Africa Standard Time Shunta Tomimatsu Kuriko Kudo Taiki Moriyama Tomohiko Moriyama Tomoaki Taguchi Shuji Shimizu <p><strong>Introduction: </strong>Videoconferencing (VC) is useful for physicians who need to learn about many cases without moving from one institution to another. However, this advantage can be hampered by technical issues. This study aims to analyse the factors relating technical support that cause technical issues in regular multiparty medical VC to provide high-quality VC to meet participants’ demands.<strong> Methods: </strong>The study includes large multiparty VC between the Kyushu University Hospital Department of Paediatric Surgery and different institutions within Japan that were held from September 2014 to January 2017. Technical tests, a “previous-week test” and a “last-hour test,” were conducted for checking conditions prior to the VC. The chi-square test was used for factors: participation for previous-week and last-hour test, and attendance by an engineer VCs in each participating institution. A questionnaire survey was distributed among the participants to collect feedback on the quality of VC, ease of preparation and necessity of previous-week testing.<strong> Results: </strong>Participation in the last-hour test (P=0.002) and the presence of an engineer (P=0.049) significantly decreased overall technical issues. The last-hour tests significantly decreased disconnection (P=0.015) and audio (P=0.019) issues. The engineer’s attendance decreased content-sharing issues (P=0.027). Participants reporting “very good” and “good” audio and visual quality were 92% (109/118) and 96% (105/110). Eighty-three percent of participants (82/99) found the preparation “very easy” or “easy”; while 61% (63/103) found the previous-week test, “unnecessary.”<strong> Conclusions: </strong>Based on our study, “engineers’ attendance” and “last-hour” technical testing significantly reduced technical problems; these factors help provide high-quality output VC and meet the needs of the participants.</p> 2018-05-05T00:00:00South Africa Standard Time ##submission.copyrightStatement## Development of a Smartphone Application to Enable Remote Monitoring in the Outpatient Management of Cirrhotic Ascites 2018-12-01T11:57:27South Africa Standard Time Phil Ha Sherryne Warner Paul O’Neil Patricia Anderson William Sievert <p>Patients who develop hepatic decompensation with ascites have a poor prognosis and often experience other complications including spontaneous bacterial peritonitis, hepatic encephalopathy and variceal bleeding. We hypothesised that smartphone (SP)-enabled remote monitoring of patients with ascites may enable early detection of infection and acute decompensation, facilitate timely intervention and improve patient outcomes. <strong>Aim:</strong>&nbsp; We aimed to design, develop and implement a remote monitoring system (RMS) for outpatients with cirrhotic ascites. <strong>Method:</strong> We undertook surveys with patients and hepatologists to quantify the demand for a RMS and identify issues regarding implementation. A smartphone and a web-based application were developed as a RMS. Patients used the RMS in a 6-week prospective non-randomised trial.&nbsp; <strong>Results</strong>: We surveyed 27 patients (mean age 56 years, 18 (67%) were male, 16 (59%) had Childs Pugh B cirrhosis, and 20 (74%) had a history of alcoholic liver disease) and 5 hepatologists. There were 19 patients (70%) who reported that they would use a RMS. The RMS was used by 10 patients for a mean 53.8days (11-70), who entered 20.6 (0-71) updates. A total of 18 automated alerts occurred. 22% of automated alerts resulted in clinically significant changes to management, such as inpatient admission n=1 (6%), early outpatient appointment n=1 (6%) and reinforced adherence n=2 (11%). <strong>Conclusion</strong>:&nbsp;&nbsp; We have successfully designed an internet-enabled RMS for outpatients with cirrhotic ascites that could be used as an adjunct to existing outpatient services. Future studies will optimise the alert thresholds, assess long-term patient adoption and quantify clinical impact.</p> 2018-03-29T14:49:32South Africa Standard Time ##submission.copyrightStatement## Africa Radiation Oncology Network (AFRONET): an IAEA Telemedicine Pilot Project 2018-12-01T11:59:32South Africa Standard Time Eduardo Rosenblatt Rajiv Ranjan Prasad Kirsten Hopkins Alfredo Polo Ntokozo Ndlovu Mohamed Saad Zaghloul Gerald Paris Lotfi Kochbati <p>In developing countries, many centres work in relative isolation with limited access to up-to-date published literature, international meetings, and expert opinion.<strong> Methods: </strong>The International Atomic Energy Agency established the AFrica Radiation Oncology NETwork (AFRONET) as a pilot project for African countries. Through videoconferencing, cancer professionals discussed and reviewed challenging cancer cases. Monthly virtual meetings took place among radiotherapy centres in Africa. During these meetings, individual cases were presented and discussed, and a consensus recommendation for treatment was reached. The platform was also used for regularly scheduled webinars.<strong> Results: </strong>64 monthly meetings were held and 154 cases have been discussed. The average number of participating centres was 9 per session. Central nervous system tumours were the most common and 5.2% of patients were HIV positive. The profile of diseases and comorbidities represents a window into the typical patient population of radiotherapy centres in Africa. Videoconferencing discussions strengthened clinical decision making for oncology patients. Both the case discussions and the webinars contributed to resident education in participating centres.<strong> Conclusions: </strong>This pilot experience has shown that it is feasible to use available telemedicine tools to establish a network for case discussions and education in radiation oncology in African countries.</p> <p><strong>&nbsp;</strong></p> 2018-04-09T09:21:48South Africa Standard Time ##submission.copyrightStatement## Psychosocial Implications of Prenatal Telehealth Genetic Counselling: A Systematic Review 2018-12-01T11:16:58South Africa Standard Time Lauren Beretich Jane DeLuca Julia Eggert <p><strong>Introduction: </strong>Telehealth is a growing service delivery model in clinical genetics and genetic counselling. Despite its popularity, telehealth genetic counselling (TGC) is often not incorporated into prenatal genetic services. <strong>Methods:</strong> A literature review was conducted to identify peer-reviewed, original research articles, which examined the psychosocial implications (e.g. satisfaction) of prenatal TGC. Using the PubMed database, searches were conducted using the following key terms: “Telehealth Genetic Counselling”<em>, “</em>Prenatal Genetics Telehealth<em>”</em> and “Telegenetics<em>”</em>. <strong>Results: </strong>The search returned 82 articles; only five articles assessed the psychosocial implications of prenatal TGC. The TGC delivery methods varied among studies, but results consistently revealed positive responses, most notably patient satisfaction. <strong>Conclusions:</strong> Further use and research of TGC are needed to better understand the social implications of this service delivery model for prenatal populations. This information is essential to guide clinical care for prenatal populations.</p> 2018-12-01T11:16:54South Africa Standard Time ##submission.copyrightStatement## A Review of Current Heart Failure Apps 2018-12-01T11:26:49South Africa Standard Time Pavneet Singh Anwar Jelani Nakul Sharma Anmol Kapoor <p><strong>Background:</strong> Heart disease is the second leading cause of death in Canada, with tremendous economic impacts on the healthcare system. Currently, there are several smartphone based heart failure (HF) apps available for patients. These apps provide information to patients regarding HF, and how to monitor and manage their condition. This review describes the current literature on HF apps, and describes the features offered by these apps. <strong>Methods and Results</strong>: Peer-reviewed literature was searched and revealed only a limited number of studies (8) related to HF apps, including HeartMapp, SUPPORT-HF and CardioManager. &nbsp;A Google-based grey literature search was conducted, and Google Play and the Apple Store were also searched to identify additional HF-related apps. These searches revealed several other HF-related apps (total 11), the features of which are described in the current review. <strong>Conclusion:</strong> This review will help healthcare providers select apps for themselves and recommend HF apps to their patients that provide the most suitable disease and management information and monitoring capability. The insight will also help software developers design apps in the future that will provide better support to patients with HF and help the healthcare providers monitor their condition better.</p> 2018-11-15T09:21:50South Africa Standard Time ##submission.copyrightStatement## Securing the Evidence and Theory-based Design of an Online Intervention Designed to Support Midwives in Work-related Psychological Distress 2018-12-01T12:01:44South Africa Standard Time Sally Catherine Pezaro <p>The psychological wellbeing of midwives can be linked to the safety and quality of maternity care. As such, work-related psychological distress in midwifery populations must be addressed in order to meet the United Nation’s Sustainable Development Goals for maternal health. Earlier research maps out a global vision, using telemedicine and e/mHealth for the design and development of an online intervention designed to support midwives in work-related psychological distress. This paper outlines how the evidence and theory-based design of such an intervention has been secured via a narrative review, a critical realist review, a 2-round Delphi study and a mixed-methods systematic review of the literature. Findings suggest that this online intervention should be designed to provide anonymity and confidentiality for midwives seeking support online. 24-hour mobile access, effective moderation, an online discussion forum, and additional legal, educational, and therapeutic components are also indicated for collation in a ‘One stop shop’ online. Additionally, a simple user assessment may be used to identify those people deemed to be at risk of causing harm. The comprehensive design for this particular intervention is outlined using a validated checklist and guide. This particular design has been informed by the pathways disclosure model and the revised transactional model of occupational stress and coping. This research has been guided by the Medical Research Council’s framework for developing complex interventions. Future research in this field is also suggested. Should this intervention be developed and tested more widely, both midwives and maternity service users may experience safer, more productive and higher-quality maternity care.</p> 2018-04-14T08:27:33South Africa Standard Time ##submission.copyrightStatement## Childbearing Women’s Perception About the Use of mHealth for Maternal Health Information in Rural Communities, Ile-Ife, Nigeria 2018-12-01T12:03:42South Africa Standard Time Titilayo Dorothy Odetola Love Bukola Ayamolowo Sunday Joseph Ayamolowo <p><strong>Background:&nbsp;&nbsp;&nbsp; </strong>Poor access and utilisation of maternal health services among rural women is a major contributor to the high maternal mortality in Nigeria. Inadequate healthcare facilities and personnel in the rural communities are some of the major factors militating against women’s access and use of maternal health services. Harnessing mobile health (mHealth) in supporting health services delivery to widely-dispersed women will improve access to reproductive healthcare and reduce maternal mortality. This study aimed at assessing women’s perception about the use of mHealth for maternal health information in rural communities.<strong> Methods: </strong>This was a descriptive community-based cross-sectional study that involved 403 women of childbearing age (15 to 49 y) who gave birth within the five years prior to the study. Data were collected over two weeks using structured questionnaires.<strong> Results: </strong>The majority of the women possessed mobile phones, 91%, but only 48% currently used them for maternal health information and 87.3% had a positive perception about use of mHealth for maternal health information. Women who had positive perception had higher odds of accessing a health institution for delivery compared to those who had poor perception (OR=1.72, SE=0.6, CI=0.92-3.22). <strong>Conclusion: </strong>Women had positive perceptions about use of mHealth but current use of mobile phone for maternal health information was poor. Innovative methods like mHealth to strengthen maternal health services delivery for the hard to reach populations are urgently needed to support Nigeria efforts towards desirable global maternal and child health targets against year 2030.</p> 2018-05-08T09:11:23South Africa Standard Time ##submission.copyrightStatement## The Role of e-Health in Disasters: A Strategy for Education, Training and Integration in Disaster Medicine 2018-12-01T12:06:42South Africa Standard Time Tony Norris Jose Gonzalez David Parry Richard Scott Julie Dugdale Deepak Khazanchi <p class="Normal1">This paper describes the origins and progress of an international project to advance disaster eHealth (DEH) – the application of eHealth technologies to enhance the delivery of healthcare in disasters. The study to date has focused on two major themes; the role of DEH in facilitating inter-agency communication in disaster situations, and the fundamental need to promote awareness of DEH in the education of disaster managers and health professionals. The paper deals mainly with on-going research on the second of these themes, surveying the current provision of disaster medicine education, the design considerations for a DEH programme for health professionals, the key curriculum topics, and the optimal delivery mode.</p> 2018-03-29T14:49:30South Africa Standard Time ##submission.copyrightStatement## Pinpointing What is Wrong With Cross-Agency Collaboration in Disaster Healthcare 2018-12-01T12:08:26South Africa Standard Time Reem Abbas Tony Norris David Parry <p class="Keywords">A disaster is an event in which a hazard has a destructive environmental or ecological impact on such a scale that the effects cannot be managed within local community resources. In disaster healthcare, the main responders to provide emergency relief are usually emergency management and health personnel. Although these two sectors share the same vision of providing public health services to disaster victims, post-disaster analysis reflects poor communication between them leading to delayed, substandard and even unavailable healthcare. This paper investigates the barriers to smooth and effective communication between health and emergency management personnel in a disaster, with the aim of pinpointing possible points of improvement. The paper presents a comprehensive review of the available literature on the subject and suggests suitable interventions to enhance healthcare delivery through cross-agency collaboration and information exchange based on a projected telehealth system.</p> 2018-03-29T14:49:30South Africa Standard Time ##submission.copyrightStatement## Design Considerations for a Disaster eHealth Appliance 2018-12-01T12:10:34South Africa Standard Time David Parry Samaneh Madanian Tony Norris <p class="ISfTEHkeywords">Disaster eHealth is a new area of research and endeavour. In order to make a practical contribution Disaster eHealth approaches should consider the role of a Disaster eHealth appliance. Both disaster management and disaster medicine may find that such approaches allow critical information to be gathered and situational awareness improved. This paper proposes the development of a Disaster eHealth appliance to support self-care of chronic disease and caregiving by others. Injuries and disease caused by the disaster may be also supported by this approach. It also attempts to address some of the potential problems and suggest some solutions for the use of such appliances. Re-using existing devices may offer a relatively low-cost and sustainable approach to providing such devices, and infrastructure to use them.</p> <p><strong><em>&nbsp;</em></strong></p> 2018-03-29T14:49:30South Africa Standard Time ##submission.copyrightStatement## The Role of Telehealth in Disaster Management: Lessons for the Philippines 2018-12-01T12:13:15South Africa Standard Time Kristine Mae Magtubo Monica Sunga Manuel John Paul Gaspar Portia Grace Fernandez Marcelo <p>According to the WorldRiskIndex 2016, the Philippines is the third country most at risk of disasters in the world. Typhoon Haiyan, the strongest on local record, caused widespread destruction to life and property. Current disaster management strategies in the country do not include telehealth as a formal tool in disaster mitigation, response, or recovery. This study reviewed research incorporating telehealth in disaster management from multiple low and lower middle income countries like the Philippines to address this gap by identifying lessons the country might be able to adopt. Studies show that most initiatives centre on evaluating telehealth’s effectiveness during the response phase. Unsurprisingly, mobile technology and satellite communications predominated, and most projects were launched using donor funding. Use of telehealth in disaster management in the Philippines could begin by recognising and including telehealth in formal government protocols. The government could leverage the National Telehealth Service Program of the University of the Philippines National Telehealth Center. Documentation and systematic research on telehealth’s expected positive contributions to disaster preparedness and response should also be initiated.</p> 2018-03-29T14:49:31South Africa Standard Time ##submission.copyrightStatement## 23rd Conference of the International Society for Telemedicine and eHealth and the 23rd Finnish National Conference on Telemedicine and eHealth. Helsinki - Stockholm - Helsinki 15th-17th March 2018 2018-12-04T16:45:25South Africa Standard Time Maurice Mars 2018-12-04T00:00:00South Africa Standard Time ##submission.copyrightStatement## 1st International Conference on eHealth and Telemedicine (ICEHAT) Kathmandu 1st - 3rd November 2018 2018-12-04T13:54:02South Africa Standard Time Maurice Mars 2018-11-18T00:00:00South Africa Standard Time ##submission.copyrightStatement## 22nd Conference of the International Society for Telemedicine and eHealth and Moroccan Society for Telemedicine and eHealth 2017 - Casablanca 2017 2018-12-04T13:51:55South Africa Standard Time Maurice Mars 2018-05-17T14:55:21South Africa Standard Time ##submission.copyrightStatement##