Telemedicine for Chronic Obstructive Pulmonary Disease: A Review
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Charles Sturt University ITC571: Emerging Technologies and Innovation Project Type: Review Chronic Obstructive Pulmonary Disease with the help of telemedicine 1
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Table of content 1.Introduction to Telemedicine 1.1.Phenomenology 1.2.Methods 1.3.Applications available 2.Background of Chronic Obstructive Pulmonary Disease 3.Approach 3.1.Architecture 3.2.Cooperation 3.3.Intervention 3.4.Data acquisition 3.5.Data analysis 4.Results 4.1.Body structure 4.2.Living withChronic Operative Pulmonary Disease 4.2.1.Physical limitations 4.2.2.Mental limitations 4.3.Getting care through Telemedicine 4.3.1.Accessibility 4.3.2.Support 4.3.3.Analytical insights 5.Discussion 5.1.Unlocking the limitations of disease through telemedicine 6.Conclusion 7.Abbreviation 8.Table of content 9.References 2
1.Introduction to Telemedicine Telecommunication and medicine are brought together to cater for health services remotely known as telemedicine. It was first introduced in the early 1970s. Through telemedicine patients can get consistent access to the preferred services, decreases the cost and increase the quality of productivity and care and also disregard the distance barriers. Patients use telemedicine when needed urgent access to the medical services and cannot travel to the specialist. It also provides immense opportunities to the medical students from the expertise specialists. Telemedicine is accessible and evolving constantly as it comes with new advancements in technology, and adapts the rapids changes in health needs of the societies(Edoh, Pawar, & Kora, 2018). Telemedicine is completely distinguished from telehealth, telehealth is restricted to the physicians only and telemedicineservicesareopentohealthprofessionalsfromdifferentfieldsincluding pharmacists, nursing, and others. Telemedicine applications provoke types of transmissions like text, audio, video, and image with varying Quality of Services requirements. In order to deliver high quality of services, QoS requirements are accomplished by network providers. As per the QoS, telemedicine services are required to have reliability, availability and low delay(Edoh et al., 2018). The prevalence of chronic neurological disorder increases with the old age people, access to the neurologist care is likely to worsen in various regions. The telemedicine is defined as the use of real-time and also the video conferencing for the delivery of medical care. It can also be used for improving the access to neurologist care for patients who are suffering a range of chronic disorders as cancer, dementia, and others. Many of the previous studies show the advantage of telemedicine in the delivery of healthcare facility for the customer. Telemedicinecanbecategorizedintwoterms:Storeandforward,andreal-time interactive.(Grogan et al., 2017)Gathering medical data and transmitting it to a practitioner or a medicalspecialistforassessmentisdefinedasstoreandforward.Inthiscategoryof telemedicine, the patient’s assessments are recorded in actual time and practitioner reviews at the later time, based on this patients is recommended further care. This method of telemedicine would be acceptable for providers and patient and gives an alternate path that increases the number of patients available to assess by telemedicine.(Pulley et al., 2018)This method has been rated high because of its mobility feature, severe mobility patients can get treated by staying back home. In spite of being so many benefits, store and forward has some difficulty in some areas where telemedicine has included with the video file. Size of the video file might 3
sometimes big enough that there's no adequate capacity of storage is not available to store. (Pulley et al., 2018)The second category is real-time interactive telemedicine where there’s an interactionbetweendoctorsandpatientspartedwithdistance.(Sasikala,Indhira,& Chandrasekaran, 2018) 4
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1.2 Phenomenology Phenomenology is a generalized analysis of the appearance of things which is related with an appearance anything that conscious for individual. The presumption of phenomenology is that everythingthatcomestoourconsciousnesshasthecertainvalueandislegitimatefor investigation. COPD patients assume that there is no healing for this disease and it will only get worse, phenomenology helps in finding and confront their experiences and emotions got during the exacerbation. It is monitored especially right after the exacerbation- as this might only time nurses can read the state of mind and have a chance to intervene positively.(Rosa et al., 2017) 5
2. Background of Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease has basically affected the people aged above 25. COPD has effecting symptoms of burden and very less controlled symptoms that needed to have the greater level of care. This is characterized under intermittent worsening of symptoms which leads to acute exacerbations.(Central, 2016)As per the several pieces of evidence, more or less half of all exacerbations are caused by bacteria. Respiratory tract bacteriology exacerbations, immune's responses to bacterial pathogens, relations of airways tenderness with outcomes of sputum ability during exacerbations are included in the evidence. Haemophilus influenzae, Chlamydia pneumoniae, Moraxella catarrhalis, and Streptococcus pneumoniae are the most important exacerbations of this disease caused by the bacteria.(Murphy & Sethi, 2002) The factors that define the severity of COPD (simple or complicated) are how severe the lung disease is, how frequently the patient have the exacerbation or does a patient have comorbid conditions. If it is a simple COPD, patients get treated with the macrolide, or a spectrum oral cephalosporin; if it is diagnosed as complicatedCOPD, it is treated with clavulanate/amoxicillin or fluoroquinolone.(Barken, Thygesen, & Söderhamn, 2018) 6
3. Approach 3.1 Architecture Figure 1: Organization of a telemedicine application in the three systems (Source: Finet, et. al., 2015) Figure analysis-The above figure is depicting the process of telemedicine which can be used by the patient suffering from chronic disease. To assure the safety and quality of the user, it is important to combine thedata transmission system, patient system, and data processing systembecause it helps in providing proper care to the patient. The overall telemedicine process for the patient will work with the help of data connection process. In the very first step, the patient system will be used for the monitoring of medical database effectively and actively. Through this, the blood pressure, glucose meter and weight measurement are used to be done (Palutke and Freiling, 2018). The daily medical data of the customer is collected and gathered in the database so that the medical worker will be able to match the daily changes in the human body. The data transmission among the patient home and medical center is done with the help of internet. The data processing and archiving system are located in the hospital for providing proper care and medicine to the user. 7
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Figure 2: Redundancy between different application systems focusing on different chronic diseases (Source: Finet, et. al., 2015) Figure analysis-The above figure is showing the common functionalities and elements which is used by the patient suffering from chronic disease (Gøeg, et. al., 2018). Any of the changes in the human body is directly transferred to the device through the internet so that the medical worker will be able to get aware of it. 3.2 Cooperation It can be pretty hectic in life to make time for ourselves in the busy, constantly functioning day. Although between busy day, set schedules, and limited availability of professional assistance, leading a healthy life becomes much of a burden than a responsibility or liability. Telemedicine permits an individual to discuss the curious cases, changing lifestyles, and visible undefined or misunderstood symptoms with a doctor through phone or online communication at whichever moment, time, and situation comfortable to the individual (Rush, et. al., 2018). Telemedicine Australia (TMA) was founded by Dr. Ash Colines from Tamora in 2010. The firm provides peripherals and telemedicine equipment, telemedicine carts from remote care centers and telemedicine software with residential aged care services and hospitals (Rezaeibagha and 8
Mu, 2018). The HQ of TMA has an active functioning training center that provides hands-on telemedicine training sessions and experience with ways for trainees to join actual telemedicine consultation during such training sessions. The clinic of TMA includes telemedicine consultation for individuals habituating in Riverina area (Harting, et. al., 2018). On the basis of the latest survey, the telemedicine clinic has crossed more than 800 telemed consultations regard people of Temora, and the communities living around it. 3.3 Intervention Telephone counseling Telephone counselling is not one of the most admired methods of smoking cessation. Telephone counselling has been one of the earliest interventions reviewed by Cochrane Collaboration. Although the review concludes that telephone counselling does help smoke addicts who often look for an escape or change to lead them out of the consistent lifestyle (Lesher and Shah, 2018). Telephone ‘quitliness' refers to access support for smokers, the process of call-back counselling which makes it even more useful. However, there are barricades on the number of a call made and acceptable other than smoking cessation, to analyze and observe the benefits and outcomes of the proactive telephonic counselling. Forced spirometry The issues that turn up with early diagnosis of CRD and management are seen in higher prevalence, such as COPD (Chronic obstructive pulmonary Disease) and as well of Asthma. For diagnosis and management of respiratory diseases, some forced spirometry is expected and required. According to a survey conducted online that stated that there are about three main functional web-based applications set up for primary care: 1.Educational material accessibility for CPD (Continued Professional Development) 2.Aid and support for experts conducted quality tests 3.Assistance for interpretation of lung function Computed tomography and diagnostic support A CT scan, a non invasive test which precisely is painless, is used to monitor chest radiography to check respiratory issues and to identify the cause of change in lung function, the analyses and 9
deciphering of the symptoms visible in an individual, such as shot and quick breathing (Fortis, et. al., 2018). The understanding and ability to analyze a CT scan requires the wide knowledge of the subject, ability to understand the medical terminology, specialized training, the transferring movement of CT images to one professional to the other. In order to study CT review on the borderline three things are required: 1.CT Scan Machine 2.A functioning transmission network to send the file from one place to another 3.A high-quality system to observe the displayed image on its screen (Michel-Macarty, et. al., 2018). 3.4 Data acquisition The data acquisition is simply the process used for sampling the signals which help in measuring the real work condition and changing the sample into the numeric value with the help of the computer. For the transferring of data from a patient to the doctor, the data acquisition system plays a tremendous role as it converts the data into numerical value so that it can easily be transferred. The data acquisition system used in this research consists of three essential elements which are the sensor, signal conditioning an analog to digital converter (Garvey, et. al., 2018). The sensors used in the research is also known as the transducers which help in converting the real-time phenomenon into force, movement, signals, and others so that the receiver will easily be able to measure the output. While choosing the sensors for developing the architecture, many of the factors are considered as the accuracy of the sensor, signal conditioning and many more. Figure-Data acquisition system 10 Sen sor s Signal condi tionin g Analog- to- Digital Conver ter
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Signal conditioning is vital because it helps in making quality measurement over the signal. The signal conditioning used in the research architecture includes the Wheatstone bridge completion and cold junction compensation. While converting analog to digital, the chip takes data directly from the environment and convert into the discrete level so that it can easily be interpreted. The conversion is important because it helps in enabling the computer to store the signals for the future work. In general, the data acquisition system starts with the physical property which needs to be measured as light intensity, gas pressure, and others. The sensor used in the system simply changes the physical property into the electric signal so that it can easily be transferred to the system. The signal conditioning is important because it helps in providing suitability to the hardware which is being used in the system. Once the data is digitalized then it cannot be encoded to correct the transmission error. 3.5 Data analysis Data analysis is the process which is used to discover useful things for supporting the decision- making process of the system. Following are the data analysis process used in the research for getting an effective outcome: Figure: Data analysis process 11 Data requirmentData collection Data processingData cleaning Data analysisCommunication
Figure analysis-in the above image, the data analysis process are discussed which are used in the research project. The first step is linked to the specification of data requirement which is done by secondary data collection. The data requirement analysis is made as per the issue rise in the solution.In the second step, the required data and information are collected from books, blogs, journals and others in a specified form (Peters and Weber, 2018). The data which are collected through secondary data collection process will be processed and organized with the help of relevant analysis tool. The error and issue in the solution will be cleaned for prevention the issue which can be responsible in affecting the outcome of the research. The data which are processed, organized and cleaned are ready for analysis. This helps in making an effective decision regarding the outcome of the research. The result of the data analysis process will be communicated to the end user of the system. 12
References Barken, T. L., Thygesen, E., & Söderhamn, U. (2018). Unlocking the limitations: Living with chronic obstructive pulmonary disease and receiving care through telemedicine—A phenomenologicalstudy.JournalofClinicalNursing,27(1-2),132-142. doi:10.1111/jocn.13857 Central, P. (2016). Respiratory Tract Diseases and Conditions; New Lung Diseases Study Findings Have Been Reported by Investigators at National Heart Lung and Blood Institute (Smart Technology in Lung Disease Clinical Trials).Health & Medicine Week, 985. Edoh, T., Pawar, P., & Kora, A. (2018). Evaluation of Telemedicine Systems User Satisfaction in Developing Countries: The Case of Mali and Senegal.International JournalofE-HealthandMedicalCommunications(IJEHMC),9(3),62-78. doi:10.4018/IJEHMC.2018070104 Grogan, A., Coughlan, M., Prizeman, G., O' Connell, N., O' Mahony, N., Quinn, K., & McKee, G. (2017). The patients’ perspective of international normalized ratio self‐testing, remote communication of test results and confidence to move to self‐management. Journal of Clinical Nursing, 26(23-24), 4379-4389. doi:10.1111/jocn.13767 Murphy, T. F., & Sethi, S. (2002). Chronic Obstructive Pulmonary Disease.Drugs & Aging, 19(10), 761-775. doi:10.2165/00002512-200219100-00005 Pulley, M. T., Brittain, R., Hodges, W., Frazier, C., Miller, L., Matyjasik-Liggett, M., . . . Berger, A. R. (2018). Multidisciplinary ALS Telemedicine Care: The Store and Forward Method.Muscle & nerve. doi:10.1002/mus.26170 Rosa, F., Bagnasco, A., Ghirotto, L., Rocco, G., Catania, G., Aleo, G., . . . Sasso, L. (2017). Experiences of older people following an acute exacerbation of COPD: a phenomenological study.Journal of Clinical Nursing, 27(5-6). doi:10.1111/jocn.14189 Sasikala, S., Indhira, K., & Chandrasekaran, V. M. (2018). Performance prediction of interactivetelemedicine.InformaticsinMedicineUnlocked,11,87-94. doi:10.1016/j.imu.2018.03.003 Harting, M. T., Wheeler, A., Ponsky, T., Nwomeh, B., Snyder, C. L., Bruns, N. E., ... & Shah, S. R. (2018). Telemedicine in pediatric surgery.Journal of pediatric surgery. 13
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Rush, K. L., Hatt, L., Janke, R., Burton, L., Ferrier, M., & Tetrault, M. (2018). The efficacy of telehealth delivered educational approaches for patients with chronic diseases: A systematic review.Patient education and counseling. Peters,G.,&Weber,R.(2018).dynXcube–CategorizingDynamicData Analysis.Information Sciences. Palutke, R., & Freiling, F. (2018). Styx: Countering robust memory acquisition.Digital Investigation,24, S18-S28. Gøeg, K. R., Rasmussen, R. K., Jensen, L., Wollesen, C. M., Larsen, S., & Pape- Haugaard, L. B. (2018). A future-proof architecture for telemedicine using loose-coupled modules and HL7 FHIR.Computer methods and programs in biomedicine,160, 95-101. Rezaeibagha, F., & Mu, Y. (2018). Practical and secure telemedicine systems for user mobility.Journal of biomedical informatics,78, 24-32. Lesher, A. P., & Shah, S. R. (2018, April). Telemedicine in the perioperative experience. InSeminars in pediatric surgery(Vol. 27, No. 2, pp. 102-106). WB Saunders. Fortis, S., Sarrazin, M. V., Beck, B. F., Panos, R. J., & Reisinger, H. S. (2018). ICU TelemedicineReducesInterhospitalICUTransfersintheVeteransHealth Administration.Chest. Michel-Macarty,J.A.,Murillo-Escobar,M.A.,López-Gutiérrez,R.M.,Cruz- Hernández, C., & Cardoza-Avendaño, L. (2018). Multiuser communication scheme based onbinaryphase-shiftkeyingandchaosfortelemedicine.Computermethodsand programs in biomedicine,162, 165-175. Garvey, C., Singer, J. P., Bruun, A. M., Soong, A., Rigler, J., & Hays, S. (2018). Moving Pulmonary Rehabilitation Into the Home.Journal of cardiopulmonary rehabilitation and prevention,38(1), 8-16. Finet, P., Jeannès, R. L. B., Dameron, O., & Gibaud, B. (2015). Review of current telemedicineapplicationsforchronicdiseases.Towardamoreintegrated system?.Irbm,36(3), 133-157. 14