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This issue is a dedicated supplement published in addition to the regular issues of 'Cerebrovascular Diseases' focussing on one specific topic. 'Cerebrovascular Diseases' is a well-respected, international peer-reviewed journal in Neurology. Supplement issues are included in the subscription.
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
Acute Stroke Management in the First 24 hours bridges the clinical application gap by offering a practice-based approach to treating ischemic and hemorrhagic stroke. The comprehensive text, written by international experts in the field of stroke care, covers all aspects of stroke care, including review of stroke systems, clinic features, neuroimaging diagnostic characteristics, and pre-hospital care and challenges. This book is an easy-to-use reference guide ideal for first responders and clinicians working in emergency medicine, neurology, neurosurgery, and critical care.
This text provides a concise, yet comprehensive overview of telemedicine in the ICU. The first part of the book reviews common issues faced by practitioners and hospital administrators in implementing and managing tele-ICU programs, including the merits of different staffing models, the challenges of building homegrown programs versus contracting for services, and the impact of state laws and payer policies on reimbursement for tele-ICU services. The second part of the book presents the current state of evidence for and against ICU telemedicine, based on clinical trials, before-and-after implementation studies, and observational data. The third part dives deeper into specific use cases for telemedicine in the ICU, including telestroke, pediatric and cardiac intensive care, and early treatment of declining patients with sepsis. Written by experts in the field, Telemedicine in the ICU is a practical guide for intensive care physicians and hospital administrators that provides all the information necessary in building and maintaining a successful tele-ICU program.
This updated second edition of Acute Ischemic Stroke: Imaging and Intervention provides a comprehensive account of the state of the art in the diagnosis and treatment of acute ischemic stroke. The basic format of the first edition has been retained, with sections on fundamentals such as pathophysiology and causes, imaging techniques and interventions. However, each chapter has been revised to reflect the important recent progress in advanced neuroimaging and the use of interventional tools. In addition, a new chapter is included on the classification instruments for ischemic stroke and their use in predicting outcomes and therapeutic triage. All of the authors are internationally recognized experts and members of the interdisciplinary stroke team at the Massachusetts General Hospital and Harvard Medical School. The text is supported by numerous informative illustrations, and ease of reference is ensured through the inclusion of suitable tables. This book will serve as a unique source of up-to-date information for neurologists, emergency physicians, radiologists and other health care providers who care for the patient with acute ischemic stroke.
This open access book focuses on practical clinical problems that are frequently encountered in stroke rehabilitation. Consequences of diseases, e.g. impairments and activity limitations, are addressed in rehabilitation with the overall goal to reduce disability and promote participation. Based on the available best external evidence, clinical pathways are described for stroke rehabilitation bridging the gap between clinical evidence and clinical decision-making. The clinical pathways answer the questions which rehabilitation treatment options are beneficial to overcome specific impairment constellations and activity limitations and are well acceptable to stroke survivors, as well as when and in which settings to provide rehabilitation over the course of recovery post stroke. Each chapter starts with a description of the clinical problem encountered. This is followed by a systematic, but concise review of the evidence (RCTs, systematic reviews and meta-analyses) that is relevant for clinical decision-making, and comments on assessment, therapy (training, technology, medication), and the use of technical aids as appropriate. Based on these summaries, clinical algorithms / pathways are provided and the main clinical-decision situations are portrayed. The book is invaluable for all neurorehabilitation team members, clinicians, nurses, and therapists in neurology, physical medicine and rehabilitation, and related fields. It is a World Federation for NeuroRehabilitation (WFNR) educational initiative, bridging the gap between the rapidly expanding clinical research in stroke rehabilitation and clinical practice across societies and continents. It can be used for both clinical decision-making for individuals and as well as clinical background knowledge for stroke rehabilitation service development initiatives.
This book offers valuable guidance to neurointensivists, other neurocritical care staff, and those desiring to develop a neurocritical care unit via a thorough discussion of neurological emergencies and neurocritical care unit organization. This comprehensive volume begins with a review of acute neurological emergencies as managed clinically in the neurocritical care unit. Topics include acute cerebrovascular, neurological, and neurosurgical disorders. The unique aspect of this book is its description of the organization of the neurocritical care unit. We focus on how other services in the hospital interact with and assist neurocritical care operations, telemedicine/telestroke, and neurocritical care personnel and their roles. A review of expected outcomes of neurocritical care conditions is also included. Neurointensivists, neurocritical care unit staff leadership, hospital administrators, and those interested in developing a neurocritical care unit will find Neurointensive Care Unit: Clinical Practice and Organization to be an invaluable guide.
"Teleneurology" refers to the use of telecommunications techniques such as the telephone, Internet, email, and videoconferencing to improve the delivery of neurology services. Containing 15 contributions from international clinicians, this volume provides an introduction to telemedicine as it is practiced in neurology today. It is divided into three sections: techniques, applications, and practical issues. Technical information has been kept to a minimum, as the emphasis is on the utility of each technique, rather than the technology itself. The editors are affiliated with the Center for Online Health at the U. of Queensland in Australia. Annotation :2005 Book News, Inc., Portland, OR (booknews.com).
This scholarly book focuses on stroke in Africa. Stroke is a leading cause of disability among adults of all ages, contributing significantly to health care costs related to long term implications, particularly if rehabilitation is sub-optimal. Given the burden of stroke in Africa, there is a need for a book that focuses on functioning African stroke survivors and the implications for rehabilitation within the African context. In addition, there is a need to progress with contextualised, person-centred, evidence-based guidance for the rehabilitation of people with stroke in Africa, thereby enabling them to lead socially and economically meaningful lives. The research incorporated in the book used a range of primary and secondary methodological approaches (scoping reviews, systematic reviews, meta-analyses, descriptive studies, surveys, health economics, and clinical practice guideline methodology) to shed new insights into African-centred issues and strategies to optimise function post-stroke.