To develop a workforce with a practical working knowledge of Telemedicine and competence in the ethical use of Telemedicine and Tele-education.

Transcription

1 Telemedicine Training Outline This training programme is aimed at both health workers who will be using Telemedicine techniques as part of their clinical practice and key support personnel working in the field of telemedicine or telehealth. It is intended that the training programme will be flexible and modular allowing units to be selected and combined depending on the participating target group. Mission To develop a workforce with a practical working knowledge of Telemedicine and competence in the ethical use of Telemedicine and Tele-education. Objectives By the end of the Training the participants should be able to competently: Access and search for information on the internet Send and receive s (including attachments) Take and forward high quality digital photographs Demonstrate the ability to perform basic picture editing Demonstrate skill in the use of digital scanning equipment Demonstrate skill in the use of a document camera Use programs such as Skype or similar VOIP software Apply various techniques involved in synchronous telemedicine Apply various techniques involved in store and forward telemedicine Understand how to design and set up a telemedicine consultation venue Understand how to design and set up a tele-education videoconference venue Understand how to use and troubleshoot videoconferencing equipment Be able to set up point to point and multipoint videoconference using ISDN, IP and mixed ISDN and IP links Demonstrate the use of video camera technology, camera placement, lighting, angles and framing. Demonstrate an understanding and the use of; microphone technology; the range of available microphones; microphone set up; and solving audio problems associated with videoconferencing. Understand the use of peripheral diagnostic equipment (tele-stethoscopes, ophthalmoscopes, dermascopes, ENT scopes, hand-held cameras and ultrasound probes) Demonstrate skill in use of peripheral diagnostic equipment (tele-stethoscopes, ophthalmoscopes, dermascopes, ENT scopes, hand-held cameras and ultrasound probes) where appropriate Apply any Telemedicine activity according to relevant ethical and clinical guidelines Demonstrate an understanding of ethical issues relating to telemedicine Demonstrate an understanding of ethical issues relating to the practice of telemedicine Demonstrate an understanding of relevant local and regional legislative issues Demonstrate an understanding of financial and administrative issues relevant to the practice of telemedicine in their region 1

2 Pre-requisite A basic level of computer literacy (see outcomes listed in unit 1). If participants do not meet these basic criteria the pre-module has to be completed. Teaching Methodology A mixture of information sessions / lectures and practical sessions Units The programme is made up of units, which can be combined depending on the learning needs of the target groups. The programme also has key strands, which thread through all the modules and require reflection at the end of each module: - Ethics in Telemedicine - skills The units, including the introduction to computing, total up to 21 hours and can be put together to create workshops ranging from a half day to 3 days depending on the target group and the purpose of the training. In addition, specialist Telemedicine Units can be made available in the specialist areas of: Telepsychiatry Teledermatology Teleradiology Ultrasonography Ophthalmology 2

3 Introduction to s. 3 hours None Identify the relevant components of a computer Use a mouse Create a word document Send an Save a document to hard drive Save a document to a memory stick Open web browser Conduct a Google search Information Session: 1 hour What is a computer Basic Internet and Basic filing Basic MS Word Introduction to the Web Practical Session: 2 hours Individual sessions in front of a computer Activities Turning on a computer Do a mouse exercise Create a word document Create a folder and file word document Search for Telemedicine on the Web Print out article Transfer files to a memory stick Send an (Intel training disk) - : 1 per participant - Internet access - address - Web browser - MS Office or equivalent - Memory stick - Intel or similar training CD 3

4 Unit 2 Introduction to Telemedicine 1 hour Differentiate between telemedicine, tele-education and teleconferencing Differentiate between synchronous and asynchronous Telemedicine Describe the features of synchronous telemedicine Describe the features of store and forward telemedicine Identify core obstacles to the implementation of Telemedicine in their own country Identify the cost and administration implications of Telemedicine Discuss the requirements of a needs assessment Discuss the requirements of programme evaluation Information Session: 1 hour History of telemedicine Concepts, Definitions / acronyms Features of synchronous telemedicine Features of store and forward telemedicine Types of Telemedicine Costs and administration Images, DICOM and PACS Tele-education Strengths and Weaknesses of telemedicine what evidence? Telemedicine needs assessment Telemedicine evaluation Ethics, law and standards as issues Medical informatics and the Electronic patient record Specialties: Radiology, Dermatology, Home-based Care, Ultrasound, Psychiatry The Future 4

5 Unit 3 Ethics and Law in Telemedicine 1 hour List and discuss the key ethical issues in Telemedicine Identify the relevant Health Legislation that governs the practice of Telemedicine Identify issues relating to international practice of telemedicine Information Session: 1 hour Patient physician relationship Informed Consent Confidentiality and privacy Quality of care Standards - adequacy and quality of data Continuum of care Data security Liability Licensure Record keeping Protocols Tele-medical Law Prescriptions and electronic signatures Case studies Readings Ethics Legislation 5

6 Unit 4 Setting up venues 2 hours Set up a telemedicine consultation venue Set up a tele-education videoconference (VC) venue Use and troubleshoot VC equipment Set up point to point and multipoint VC using ISDN, IP and mixed ISDN and IP links Demonstrate an understanding of: the use of video camera technology; camera placement; lighting; angles and framing. Demonstrate an understanding of the : the use of microphone technology; the range of microphones; microphone set up; and solving audio problems associated with VC Understand the connection of peripheral diagnostic equipment (telestethoscopes, opthalmoscopes, dermascopes, etc) Information Session: 1 hour (In the absence of equipment) Practical Session: 2 hours Set up a Telemedicine venue and discuss o Location o Access o Equipment as per small clinic o Physical characteristics (sound proofing, lighting) o Equipment (video conference equipment, accessory videocamera, portable microphone) o Telemedicine diagnostic equipment o Room layout o Connect available tele-diagnostic equipment o Basic trouble shhoting Set up Tele-education venue and discuss o Location o Access o Size of target group o Equipment as per teaching o Physical characteristics (sound proofing, lighting, acoustics) o Equipment (video conference equipment, external speakers, radio microphones, data projector, audiomixer) o Room layout o Basic trouble shooting Reading: Telemedicine & Teleducation venue design principles Equipment Telemedicine and Tele-education rooms - VC equipment, Accessory videocamera - Portable microphone - Document camera - Phone - Fax - - External speakers, Radio microphones, -, Audiomixer - Tele-diagnostic equipment 6

7 Unit 5 Basic Telemedicine Skills - demystifying the world of technology. 1 hour : Identify the different computer options available and the relevant advantages and disadvantages of each Identify the different kinds of access to Internet and available locally Discuss different communication options Discuss the latest ICTs such as mobile phones, PDAs Information Session and demos: 1 hour How do you get access communication options o Dial up, broad band, wireless, phone cards, phones o Modem, LANs, VPN What skills are needed s o Desktops vs Laptop vs Tablets vs PC vs Smart Phone Basic requirements for PCs o Sound o Memory o Monitor o Resolution o CD/DVDs Storage o Hard drives o Flash-cards, CD/DVDs Good Practice o Back up, Virus protection, Security mhealth o Smart Phones o PDAs Health Information Systems and Medical Informatics Readings Equipment: Flash cards Laptop Tablets Smart Phone PDA Wired LAN connection Wireless connection 3G/GPRS card 7

8 Unit 6 Basic Skills Use of the Internet (1) 1 hour and 30 minutes Unit 5 Understand how the internet work Select an appropriate browser option Access the internet to: o Do a literature search o Download software o Use an IP based educational software package Information Session with demos: 30 minutes Internet history How the internet works o Browser options o Search engines o Protocols What is available o Literature search o Internet distance learning o Web pages o E-learning packages o Downloading software o IP based internet educational software (Breeze, Illuminate) o Blogs o Future of Internet Practical Session: 1 hour Individual activity Access internet and do the following: o Do a literature search on Telemedicine on Pubmed, Google, Google Scholar and Wikipedia o Do an online educational activity o View a blog - : 1 per participant - Internet access - address - web access - web browser - sound card - headphones - Online Educational Package loaded 8

9 Unit 7 Basic Skills Use of (2) 1 hour and 30 minutes Unit 5 Unit 6 Set up a web based address eg. Gmail Send an to another participant Send an with an attachment to another participant Start a chat conversation with another participant Identify the risks and ethical issues of communication. Develop a contact list Develop a group contact list Set up rules Track the delivery and status of an Archive s Use Skype Information session: 30 minutes Service Providers o Costs o SMTP and POP Types of servers o Web based vs Outlook vs Express Use of o Contacts and groups o Attachments & file size (file compression) o File extensions eg. pdf, jpg, doc etc. Other communication technologies o Chat o VOIP o Podcasts Managing s o Filing o Viruses & Security o Tracking o Archiving Practical Session: 1 hour Set up a Gmail or similar account Send an Compression of attachments Create a contact list and group Chat Set up an rule for going on holiday Listen to a podcast Use Skype to call and chat - : 1 per participant - Internet access - address - web access - web browser - sound card - headphones - Skype - Podcast on server 9

10 Unit 8 Basic Skills: Digital photography Time: 3 hours Choose a camera for their special needs Identify the main components of the camera Understand different types of memory Select from a range of file formats Compress photographs to reduce file size Edit picture to improve quality Use a flash when appropriate Differentiate between optical and digital zoom Use the macro feature Transfer image files from camera to computer Use a flat bed scanners Use 35mm slide and microscope scanners Describe the features of the DICOM standard Discuss issues related to image size and quality for radiology Take a video using a digital camera Use cell phone to take a photograph Information Session (1 hrs) Comparison of digital and film cameras Considerations when buying a camera o Budget o Ease of use Main Components of a digital camera Memory and memory cards Graphic File formats for saving images File size and image quality When to use flash Macro Photography Optical vs digital zoom Transfer of images from the camera or memory card to a computer Enhancement of images using a computer and graphic software Storage Flat Bed Scanners and PDF format o Advantages of PDF format Cropping the image or text 35mm slide and microscope slide scanners DICOM features Radiology image standards Video standards Practical (2 hours) Small groups (2-3 people ) Activities Take photographs of each other Experiment with exposure and lighting Take close up photographs (Macro ) Copy X-Ray filmpreview pictures in the camera Transfer images to a memory stick or computer Basic image enhancement and cropping on a computer Save an image in DICOM format - : 1 per participant - Internet access - address - web access - web browser - Cameras - X-Ray Films - Flat Bed Scanners - Photo-editor or similar - DICOM conversion software 10

11 Unit 9 Practical use of Store and Forward 3 hours Unit 2 Unit 3 Unit 5 Unit 6 Unit 7 Using a digital camera, save an image on a computer and send it as an attachment to a consultant at a different site. Identify the indications for store and forward technology Recognize and address the ethical issues in store and forward. Information session: 1 hour Definition/explanation of store and forward telemedicine Indications for use. Special Telemedicine Software Guidelines / contract for response time File size (picture image) and compression Ethics o Confidentiality o Security of internet o Clinical photography Practical Session: 2 hours Small groups (2-3 people) Activities Take photographs of skin condition and a macro of the eye Save image on computer Edit and compress picture to given address. Equipment - : 1 per participant - Internet access - address - web access - web browser - Cameras - Photo Editor 11

12 0 Tele-education 2 hours Unit 2 Unit 3 Unit 5 Unit 6 Unit 7 Understand the use of teleconferencing equipment for the use of tele-education. Demonstrate skill in use of teleconferencing equipment for the use of tele-education Understand the benefits of using Scorm compliant learning objects Understand key principles of Learning Management Systems Information session: 1 hour Reasons for using Tele-education Criteria for Tele-education implementation Administration models for implementation Finance models for implementation Evaluation methodology Economic evaluation Change management Learning management systems Interoperabilibty Scorm

13 1 Telemedicine and homecare introduction 2 hours Unit 2 Unit 3 Unit 5 Unit 6 Unit 7 Understand the use of peripheral diagnostic equipment (telestethoscopes, opthalmoscopes, dermascopes, ENT scopes, hand-held cameras and ultrasound probles) Demonstrate skill in use of peripheral diagnostic equipment (telestethoscopes, opthalmoscopes, dermascopes, ENT scopes, hand-held cameras and ultrasound probes) where appropriate. Apply various techniques involved in the synchronous ans store and forward telemedicine according to the relevant clinical guidelines. Recognise and address ethical issues in the practice of Telemedicine (Still to be developed) 13