Yes, I am publishing a paper on this topic. Will let you know when it is available online. It is describing a virtual outreach clinic for diabetes in Queensland, Australia.

Yes, in Brazil. Please, see http://www.ufsj.edu.br/portal2-repositorio/File/tecnologiasemsaude_pesquisa/CostBenefitOfTelecardiology.pdf

I may help with telemedicine use in condition for seniors- (65+) living alone in city (250k) and people with disabilities living alone. Mostly, their health status was degradating due to age. Results compared data before and after, used devices and software.

http://www.abdn.ac.uk/crh/uploads/files/Telehealth_Evaluation_Report_Final.pdf

The US Department of Veterans Affairs uses telehealth technology to deliver quality health care in rural areas. Contact Adam Darkins, MD chief consultant of care coordination services at the Department of Veterans Affairs, Washington DC . [email protected] For a publication on the VA experience: http://www.nap.edu/openbook.php?record_id=13466&page=99

Yes. We have published case studies for real-time remote NICU consultation in both Australian and Canadian contexts. We transmit and analyse high speed physiological data together with an audiovisual signal. I am still actively researching in this area.

In which region? My PhD work (HIV/AIDS and mobile technologies for positive health outcomes) was on both rural and urban metropolis of Lagos State, NIGERIA.

Thanks to all who have contributed so far. I have really appreciated the links

Isabelle

If you haven't looked at it already I would suggest you look at the ITTS website - ITTS is a Northern Periphery Programme project - Implementing Transnational Telemedicine Solutions - they have been doing some interesting work.

My rural research mental health participants tell me that telepsychiatry is under utilized by carers (they are told they can't have access to it), that it is patchy reception - that people prefer face to face consultations (not fly in fly out - but local) and that they battle to have digital TV reception or phone connection in rural areas - so it is not logical to assume that telehealth would work for them either. Manuscript in progress about this and research findings will be presented at Int Conf Mental Health Nurses in October in Perth where an oral paper has been accepted.

New Zealand uses telehealth in many areas - see http://www.stuff.co.nz/technology/digital-living/4474914/Telehealth-rethink-for-doctors#Scene_1 for example of how it is changing from high cost hitech to lower cost soltions. See also Telehealth - Bringing specialists to rural areas at http://www.youtube.com/watch?v=y5FNF31g-2M

Thanks Andrew, Rhonda and Inga, these are really interesting and great leads.

We have just published a paper in the journal Rural and Remote Health developing a model to identify the Carbon cost of health related travel. We hope to be able to use that as one of the measures when we conduct a cost benefit analysis of new services to the remote community of King Island. http://www.rrh.org.au/publishedarticles/article_print_2723.pdf

Yes, there are many rural case studies. Which ones you might find most relevant depends on your particular research question. I have a particular interest in the relationship between telemedicine and health systems and service models. Four case studies that I would like to draw your attention to are:

Bareiss W. Telemedicine in South Dakota: a cultural studies approach. New Media and Society. 2001;3(3):327-55. This study analysed the change in power relations as a result of rural telemedicine implementation. It is one of the few to do so and suggested that there was a danger of more power accumulating to the centre.

Cho S, Khasanshina EV, Mathiassen L, Hess DC, Wang S, Stachura ME. An analysis of business issues in a telestroke project. J Telemed Telecare. 2007;13(5):257-62. Epub 2007/08/19. This study looked at why it was difficult to implement a telestroke projece between a regional centre and several smaller rural hospitals, going into the details of clinical and financial arrangements.

Zanaboni P, Scalvini S, Bernocchi P, Borghi G, Tridico C, Masella C. Teleconsultation services to improve healthcare in rural areas: acceptance, organizational impact and appropriateness. BMC Health Serv Res. 2009;9:238. The rural area in this study was a mountainous part of Italy, and the authors noted that introducing telemedicine changed referral pathways and the relationship between primary care and secondary care services. In particular, complex and difficult patients tended to be taken over by specialist services.

Whitten P, Adams I. Success and failure: a case study of two rural telemedicine projects. J Telemed Telecare. 2003;9(3):125-9. This study compared two rural telemedicine services and analysed the differences between success and failure, success being related to better organisation and more expertise and enthusiasm from staff.

Hi Victoria,

I am very interested in the first paper you have suggested. Quite a few years ago I published a paper in Contemporary Nurse http://www.contemporarynurse.com/archives/vol/16/issue/3/article/2051/is-telehealth-the-right-tool-for-remote

At the time I was trying to argue that telehealth would change the power relationships between specialists and generalists and that the "gaze" of specialist would be extended into rural and remote practice by the use of the technology, but not necessary the understanding of the complexities of providing care in a resource poor environment.

Thanks for the other papers.

I am sorry, I don't have specific information regarding midwife use of telehealth services, I have been evaluating a mental health emergency program (references on my profile). There is a group in Canada led by Dr Jude Kornelson, who may have information you are looking for. Good luck with your research.

Hi Virginia, Unfortunately specialists have been very reluctant to get too involved with providing telehealth services to rural areas in this country. When they have done so it is more on an individual patient basis and rarely it seems do they consider the issues of rurality. So in answer to your question no, in my opinion, the gaze has not happened.

Hi Isabelle,

I know it is an old question. But you might be interested in a remote chemotherapy supervision model(QReCS) recently launched in Queensland, developed by our team at the Townsville Cancer Centre and Central integrated cancer services. This model uses telemedicine, telenursing and telepharmacy to deliver selected chemotherapy agents in small rural towns where there is shoratge of chemotherapy nurses, oncology pharmacists and oncologists. Guide can be accessed via www.health.qld.gov.au/circs/Docs/QReCS%20Guide.pdf

I am a DNP student at Georgia Southern University and I am conducting my DNP Graduate Project on implementing telepsychiatry in the rural population. I am in the phase of obtaining IRB approval; therefore I am collecting collaborative information to build a framework for my proposal. I am looking into facilities that have implemented telepsychiatry to determine challenges, benefits, barriers and stumbling blocks, and the role of DNP providers etc. Hopefully within the next 4 weeks I will be able to share more information about my project proposal. I am very excited in completing this project because I feel it would be very beneficial in this vulnerable population.

Mary

You could check out these studies:

Taylor, J., & Coates, L. (2015). Caring from a distance: the role of telehealth. Nursing times, 111(28-29), 18-20.

Taylor, J., Coates, E., Brewster, L., Mountain, G., Wessels, B., & Hawley, M. S. (2015). Examining the use of telehealth in community nursing: identifying the factors affecting frontline staff acceptance and telehealth adoption. Journal of advanced nursing, 71(2), 326-337.

Our study in rural Denmark about older people and video conferencing telehealth might be useful: Christensen, L.F., Wilson, R., Hansen, J.P., Nielsen, C.T., Gildberg, F.A., 2020. A qualitative study of patients’ and providers’ experiences with the use of videoconferences by older adults with depression. International Journal of Mental Health Nursing.. doi:10.1111/inm.12803 Please let us know if you would like to discuss further.

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