Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: utility, technical performance and service provider perspective.

Hdl Handle:
http://hdl.handle.net/10147/126172
Title:
Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: utility, technical performance and service provider perspective.
Authors:
Breen, Patricia; Murphy, Kevin; Browne, Geraldine; Molloy, Fiona; Reid, Valerie; Doherty, Colin; Delanty, Norman; Connolly, Sean; Fitzsimons, Mary
Affiliation:
Epilepsy Programme, Beaumont Hospital, Dublin 9, Ireland. maryfitzsimons@beaumont.ie
Citation:
Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: utility, technical performance and service provider perspective. 2010, 10:48 BMC Med Inform Decis Mak
Journal:
BMC medical informatics and decision making
Issue Date:
2010
URI:
http://hdl.handle.net/10147/126172
DOI:
10.1186/1472-6947-10-48
PubMed ID:
20843309
Abstract:
Formative evaluation is conducted in the early stages of system implementation to assess how it works in practice and to identify opportunities for improving technical and process performance. A formative evaluation of a teleneurophysiology service was conducted to examine its technical and sociological dimensions.; A teleneurophysiology service providing routine EEG investigation was established. Service use, technical performance and satisfaction of clinical neurophysiology personnel were assessed qualitatively and quantitatively. These were contrasted with a previously reported analysis of the need for teleneurophysiology, and examination of expectation and satisfaction with clinical neurophysiology services in Ireland. A preliminary cost-benefit analysis was also conducted.; Over the course of 40 clinical sessions during 20 weeks, 142 EEG investigations were recorded and stored on a file server at a satellite centre which was 130 miles away from the host clinical neurophysiology department. Using a virtual private network, the EEGs were accessed by a consultant neurophysiologist at the host centre for interpretation. The model resulted in a 5-fold increase in access to EEG services as well as reducing average waiting times for investigation by a half. Technically the model worked well, although a temporary loss of virtual private network connectivity highlighted the need for clarity in terms of responsibility for troubleshooting and repair of equipment problems. Referral quality, communication between host and satellite centres, quality of EEG recordings, and ease of EEG review and reporting indicated that appropriate organisational processes were adopted by the service. Compared to traditional CN service delivery, the teleneurophysiology model resulted in a comparable unit cost per EEG.; Observations suggest that when traditional organisational boundaries are crossed challenges associated with the social dimension of service delivery may be amplified. Teleneurophysiology requires a governance and management that recognises its socio-technical nature.
Item Type:
Article
Language:
en
ISSN:
1472-6947

Full metadata record

DC FieldValue Language
dc.contributor.authorBreen, Patriciaen
dc.contributor.authorMurphy, Kevinen
dc.contributor.authorBrowne, Geraldineen
dc.contributor.authorMolloy, Fionaen
dc.contributor.authorReid, Valerieen
dc.contributor.authorDoherty, Colinen
dc.contributor.authorDelanty, Normanen
dc.contributor.authorConnolly, Seanen
dc.contributor.authorFitzsimons, Maryen
dc.date.accessioned2011-03-29T15:34:18Z-
dc.date.available2011-03-29T15:34:18Z-
dc.date.issued2010-
dc.identifier.citationFormative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: utility, technical performance and service provider perspective. 2010, 10:48 BMC Med Inform Decis Maken
dc.identifier.issn1472-6947-
dc.identifier.pmid20843309-
dc.identifier.doi10.1186/1472-6947-10-48-
dc.identifier.urihttp://hdl.handle.net/10147/126172-
dc.description.abstractFormative evaluation is conducted in the early stages of system implementation to assess how it works in practice and to identify opportunities for improving technical and process performance. A formative evaluation of a teleneurophysiology service was conducted to examine its technical and sociological dimensions.-
dc.description.abstractA teleneurophysiology service providing routine EEG investigation was established. Service use, technical performance and satisfaction of clinical neurophysiology personnel were assessed qualitatively and quantitatively. These were contrasted with a previously reported analysis of the need for teleneurophysiology, and examination of expectation and satisfaction with clinical neurophysiology services in Ireland. A preliminary cost-benefit analysis was also conducted.-
dc.description.abstractOver the course of 40 clinical sessions during 20 weeks, 142 EEG investigations were recorded and stored on a file server at a satellite centre which was 130 miles away from the host clinical neurophysiology department. Using a virtual private network, the EEGs were accessed by a consultant neurophysiologist at the host centre for interpretation. The model resulted in a 5-fold increase in access to EEG services as well as reducing average waiting times for investigation by a half. Technically the model worked well, although a temporary loss of virtual private network connectivity highlighted the need for clarity in terms of responsibility for troubleshooting and repair of equipment problems. Referral quality, communication between host and satellite centres, quality of EEG recordings, and ease of EEG review and reporting indicated that appropriate organisational processes were adopted by the service. Compared to traditional CN service delivery, the teleneurophysiology model resulted in a comparable unit cost per EEG.-
dc.description.abstractObservations suggest that when traditional organisational boundaries are crossed challenges associated with the social dimension of service delivery may be amplified. Teleneurophysiology requires a governance and management that recognises its socio-technical nature.-
dc.language.isoenen
dc.titleFormative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: utility, technical performance and service provider perspective.en
dc.typeArticleen
dc.contributor.departmentEpilepsy Programme, Beaumont Hospital, Dublin 9, Ireland. maryfitzsimons@beaumont.ieen
dc.identifier.journalBMC medical informatics and decision makingen
dc.description.provinceLeinster-

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