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Objectives: The objective of this narrative review is to explore the advantages and limitations of VHs in delivering healthcare, including access to specialized professionals, streamlined communication, efficient scheduling, integration of electronic health records, ongoing monitoring, and support, transcending geographical boundaries, and resource optimization. Methods: Review of literature. Results: The national healthcare systems are facing an alarming rise in pressure due to global shifts. Virtual hospitals (VH) offer a practical solution to numerous systemic challenges, including rising costs and increased workloads for healthcare providers. VH also facilitate the delivery of personalized services and enable the monitoring of patients beyond the conventional confines of healthcare settings, reducing the reliance on waiting medicine carried out in doctors' offices or hospitals. Conclusion: VH can mirror the conventional healthcare referral system. [ABSTRACT FROM AUTHOR]

The development of virtual care options, including virtual hospital platforms, is rapidly changing the healthcare, mostly in the pandemic period, due to difficulties in in-person consultations. For this purpose, in 2020, a neurological Virtual Hospital (NOVHO) pilot study has been implemented, in order to experiment a multidisciplinary second opinion evaluation system for neurological diseases. Cerebrovascular diseases represent a preponderant part of neurological disorders. However, more than 30% of strokes remain of undetermined source, and rare CVD (rCVD) are often misdiagnosed. The lack of data on phenotype and clinical course of rCVD patients makes the diagnosis and the development of therapies challenging. Since the diagnosis and care of rCVDs require adequate expertise and instrumental tools, their management is mostly allocated to a few experienced hospitals, making difficult equity in access to care. Therefore, strategies for virtual consultations are increasingly applied with some advantage for patient management also in peripheral areas. Moreover, health data are becoming increasingly complex and require new technologies to be managed. The use of Artificial Intelligence is beginning to be applied to the healthcare system and together with the Internet of Things will enable the creation of virtual models with predictive abilities, bringing healthcare one step closer to personalized medicine. Herein, we will report on the preliminary results of the NOVHO project and present the methodology of a new project aimed at developing an innovative multidisciplinary and multicentre virtual care model, specific for rCVD (NOVHO-rCVD), which combines the virtual hospital approach and the deep-learning machine system. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this narrative review is to explore the advantages and limitations of VHs in delivering healthcare, including access to specialized professionals, streamlined communication, efficient scheduling, integration of electronic health records, ongoing monitoring, and support, transcending geographical boundaries, and resource optimization.Methods: Review of literature.Results: The national healthcare systems are facing an alarming rise in pressure due to global shifts. Virtual hospitals (VH) offer a practical solution to numerous systemic challenges, including rising costs and increased workloads for healthcare providers. VH also facilitate the delivery of personalized services and enable the monitoring of patients beyond the conventional confines of healthcare settings, reducing the reliance on waiting medicine carried out in doctors' offices or hospitals.Conclusion: VH can mirror the conventional healthcare referral system.

Purpose: A community teaching hospital serving a rural population established an intensive “hospital at home” program for patients with COVID-19 utilizing disease risk stratification and pulse oximeter readings to dictate nurse and clinician contact. Herein, we report patient outcomes and provider experiences resulting from this “virtual” approach to triaging pandemic care. Methods: COVID-19-positive patients appropriate for outpatient management were enrolled in our COVID Virtual Hospital (CVH). Patients received pulse oximeters and instructions for home monitoring of vital signs. CVH nurses contacted the patient within 12–48 hours. The primary care provider was alerted of the patient’s diagnosis and held a virtual visit with patient within 2–3 days. Nurses completed a triage form during each patient call; the resulting risk score determined timing of subsequent calls. CVH-relevant patient outcomes included emergency department (ED) visits, mortality, and disease-related hospitalization. Additionally, a survey of providers was conducted to assess CVH experience. Results: From April 22, 2020, to December 21, 2020, 1916 patients were enrolled in the CVH, of which 195 (10.2%) had subsequent visits to the ED. Among those 195 ED visits, 102 (52.3%) were nurse-directed while 93 (47.7%) were patient self-directed; 88 (86.3%) nurse-directed ED visits were subsequently admitted to inpatient care and 14 were discharged home. Of the 93 self-directed ED visits, 3 (3.2%) were admitted. A total of 91 CVH patients (4.7%) were ultimately admitted to inpatient care. Seven deaths occurred among CVH patients, 5 of whom had been admitted for inpatient care. Among 71 providers (23%) who responded to the survey, 94% and 93% agreed that the CVH was beneficial to providers and patients, respectively. Conclusions: Proactive in-home triage of patients with COVID-19 utilizing a virtual hospital model minimized unnecessary presentations to ED and likely prevented our rural hospital from becoming overwhelmed during year one of the pandemic.

IMPORTANCE COVID-19 has facilitated the rise of a new service model that combines Hospital in the Home (HITH) service provision with technology to create 'virtual hospitals', but evidence on the impact of this new model in terms of cost and clinical outcomes, compared to usual (HITH) care, is currently lacking. OBJECTIVE To assess the clinical and financial impacts of virtual care technology on HITH models of care. DESIGN Quasi-experimental study comparing outcomes of a control group receiving 'usual' home -based acute care and a virtual care cohort using remote monitoring technology while also receiving usual HITH care. SETTING AND PARTICIPANTS Adult (aged 18+ years) and paediatric (aged 0-17 years) patients admitted to the Mackay Hospital in the Home (MHITH) program between 1 August 2020 and 30 June 2021. INTERVENTION Virtual care technology. MAIN OUTCOMES AND MEASURES Readmissions within 28 days, unplanned emergency department (ED) presentations, transfers -in to facility-based hospital beds, and average length of stay. RESULTS During the study period, 151 adult and 26 paediatric patients utilised virtual care technology for the majority, or all, of their home-based acute care. Use of such technology was associated with a statistically significant reduction in risk of hospital readmission within 28 days--from 43% to 21%. The risk of hospital readmission within 28 days for the same diagnosis -related group (DRG) dropped from 18% to 4%, and the length of stay for the top three DRGs by volume decreased from a mean of 7.2 days to 4.0 days, saving an average of $3,698 per admission. Use of technology was also associated with reduced rates of unplanned ED presentations and transfers-in to traditional hospital beds compared to usual care for adults. CONCLUSIONS Our findings confirm there are clinical, economic and consumer benefits associated with embedding virtual care technology in HITH service models that warrant consideration in health systems facing capacity constraints and rising costs. [ABSTRACT FROM AUTHOR]

Importance COVID-19 has facilitated the rise of a new service model that combines HITH service provision with technology to create ‘virtual hospitals’, but evidence on the impact of this new model in terms of cost and clinical outcomes, compared to usual Hospital in the Home (HITH) care, is currently lacking. Objective To assess the clinical and financial impacts of virtual care technology on Hospital in the Home models of care. Design Quasi-experimental study comparing outcomes of a control group receiving ‘usual’ home-based acute care and a virtual care cohort using remote monitoring technology while also receiving usual Hospital in the Home (HITH) care. Main Outcomes and Measures Readmissions within 28 days, unplanned emergency department (ED) presentations, transfers-in to facility-based hospital beds, and average length of stay. Results During the study period, 151 adult and 26 paediatric patients utilised virtual care technology for the majority, or all, of their home-based acute care. Use of such technology was associated with a statistically significant reduction in risk of hospital readmission within 28 days—from 43% to 21%. The risk of hospital readmission within 28 days for the same diagnosis-related group (DRG) dropped from 18% to 4%, and the length of stay for the top three DRGs by volume decreased from a mean of 7.2 days to 4.0 days, saving an average of $3,698 per admission. Use of technology was also associated with reduced rates of unplanned ED presentations and transfers-in to traditional hospital beds compared to usual care for adults. Conclusions Our findings confirm there are clinical and economic benefits associated with embedding virtual care technology in Hospital in the Home (HITH) service models that warrant consideration in health systems facing capacity constraints and rising costs.

Background: The world is transitioning to Industry 4.0, representing the transition to digital, fully machine-driven environments and cyberphysical systems. Industry 4.0 comprises various technologies and innovations that enable development in multiple perspectives, which are implemented in many different sectors. Problem: The major challenges are the high cost, high rate of failure, security and privacy issues, and there is a need for highly skilled labor for applying healthcare data analysis. Aim: To resolve these issues, we employ the proposed system of Industry 4.0 smart manufacturing for IoT-enabled healthcare data analysis in virtual hospital systems with machine learning (ML) techniques. Methods: The proposed system contains five alternative solutions under smart manufacturing. First, the healthcare data analysis is applied for Weber's syndrome. That is, this will be used to analyze Weber's syndrome during its consistent treatment. Second, the IoT-enabled healthcare data handling system works based on edge-assisted edge computing that is used to apply IoT to the healthcare data handling system. The healthcare data analysis in virtual hospital systems uses machine learning for driving data synthesis. Finally, the Industry 4.0 smart manufacturing is applied to the IoT-enabled healthcare data analysis to realize efficient data digitization, especially in smart hospitals with smart sensors for virtual IoT-enabled devices surveillance of Weber's syndrome. Result: The data digitization based on Industry 4.0 smart manufacturing analysis is considered for data processing, storage and transmission. The proposed system is 62% more efficient than the other analyzed methods. The identification of Weber's syndrome is 69.8% more efficient than the existing midbrain stroke syndrome identification. The processing and storage of data results are 45.78% more efficient than the current encryption method. Finally, the priority-aware healthcare data analysis based on ML provides 63.4% efficient, faster and more accurate diagnoses in the personalized treatment. [ABSTRACT FROM AUTHOR]

In recent years, and particularly since the Covid-19 pandemic, telehealth has been rapidly introduced into U.S. healthcare institutions. While preliminary data and best practices are beginning to emerge, it remains unclear how chaplains are responding to this development in practice. Consequently, professional organizations have tended to lag behind the changing demands of increasingly digital professional environments. This article addresses this gap by presenting three case studies of U.S. healthcare settings where chaplains have become an integral component of telehealth infrastructure: the Mercy system, Ascension Health, and the Veteran's Health Administration of the U.S. Department of Veteran Affairs. Based on interviews with chaplains and directors of chaplaincy departments, it shows how the 'telechaplains' at these institutions have adapted to the introduction of telehealth across the continuum of care, and discusses the legal, economic, practical and theological challenges and hopes reported in each case. [ABSTRACT FROM AUTHOR]

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Abstract Background The first COVID-19 cases were diagnosed in Australia on 25 January 2020. Initial epidiemiology showed that the majority of cases were in returned travellers from overseas. One aspect of Public Health response was to introduce compulsory 14 day quarantine for all travellers returning to New South Wales (NSW) by air or sea in Special Health Accommodation (SHA). We aim to outline the establishment of a specialised health quarantine accommodation service in the context of the COVID-19 pandemic, and describe the first month of COVID-19 screening. Methods The SHA was established with a comprehensive governance structure, remote clinical management through Royal Prince Alfred Virtual Hospital (rpavirtual) and site management with health care workers, NSW Police and accommodation staff. Results From 29 March to 29 April 2020, 373 returning travellers were admitted to the SHA from Sydney Airport. 88 (26.1%) of those swabbed were positive for SARS-CoV 2. The day of diagnosis of COVID-19 varied from Day 1 to Day 13, with 63.6% (n = 56) of these in the first week of quarantine. 50% of the people in the SHA were referred to rpavirtual for ongoing clinical management. Seven people required admission to hospital for ongoing clinical care. Conclusion The Public Health response to COVID-19 in Australia included early and increased case detection through testing, tracing of contacts of confirmed cases, social distancing and prohibition of gatherings. In addition to these measures, the introduction of mandated quarantine for travellers to Australia was integral to the successful containment of COVID-19 in NSW and Australia through the prevention of transmission locally and interstate from returning travellers.

Background: The first COVID-19 cases were diagnosed in Australia on 25 January 2020. Initial epidiemiology showed that the majority of cases were in returned travellers from overseas. One aspect of Public Health response was to introduce compulsory 14 day quarantine for all travellers returning to New South Wales (NSW) by air or sea in Special Health Accommodation (SHA). We aim to outline the establishment of a specialised health quarantine accommodation service in the context of the COVID-19 pandemic, and describe the first month of COVID-19 screening.Methods: The SHA was established with a comprehensive governance structure, remote clinical management through Royal Prince Alfred Virtual Hospital (rpavirtual) and site management with health care workers, NSW Police and accommodation staff.Results: From 29 March to 29 April 2020, 373 returning travellers were admitted to the SHA from Sydney Airport. 88 (26.1%) of those swabbed were positive for SARS-CoV 2. The day of diagnosis of COVID-19 varied from Day 1 to Day 13, with 63.6% (n = 56) of these in the first week of quarantine. 50% of the people in the SHA were referred to rpavirtual for ongoing clinical management. Seven people required admission to hospital for ongoing clinical care.Conclusion: The Public Health response to COVID-19 in Australia included early and increased case detection through testing, tracing of contacts of confirmed cases, social distancing and prohibition of gatherings. In addition to these measures, the introduction of mandated quarantine for travellers to Australia was integral to the successful containment of COVID-19 in NSW and Australia through the prevention of transmission locally and interstate from returning travellers. [ABSTRACT FROM AUTHOR]

During a pandemic when hospitals are stretched and patients need isolation, the role of hospital‐in‐the‐home (HITH) providing acute medical care at home has never been more relevant. We aimed to define and address the challenges to acute home care services posed by the COVID‐19 pandemic. Planning for service operation involves staffing, equipment availability and cleaning, upskilling in telehealth and communication. Planning for clinical care involves maximising cohorts of patients without COVID‐19 and new clinical pathways for patients with COVID‐19. The risk of SARS‐CoV‐2 transmission, specific COVID‐19 clinical pathways and the well‐being of patients and staff should be addressed in advance. [ABSTRACT FROM AUTHOR]

Today, social and healthcare systems at a global level are facing constant challenges dictated by an increasing mismatch between the demand for care services and the supply of human and economic resources. Such a situation has been exacerbated in the past two years by the Covid-19 pandemic. This has led to an increase in the leverage of digitalisation, which has proved to be a crucial tool for the development and application of new organisational models at both hospital and territorial levels, thus addressing the various criticalities already present in the system. In this sense, the Virtual Hospital has emerged as a potential model for increasing effectiveness and efficiency in delivering sociomedical services. Starting from these premises, an EFTE (estimate, feedback, talk, estimate) approach was used to acquire an expert consensus within a multidisciplinary panel of academics and healthcare managers of the Veneto Region in Italy. This article reports the expert opinion on the possible application of the Virtual Hospital model in the national context, starting from the existing international evidence and good practices, highlighting the potential advantages and barriers to its implementation. Furthermore, the article analyses the most relevant areas of investment for the development of intangible assets and the acquisition of tangible assets necessary for its implementation. [ABSTRACT FROM AUTHOR]

Virtual hospital is an informational-interactive system that seeks to ensure that the benefits of modern medicine are available to everyone. The aim of this non-systematic narrative study was to review virtual hospital concept and its applications. Information collecting was conducted by literature review and visiting virtual hospitals' websites. Most of the already existing articles were about virtual hospitals modeling and its application in patients' management. Present data show that virtual hospitals' websites had some role in education, decreasing hospital infection rate, improving patient outcome, etc. In general, virtual hospitals have both many advantages and disadvantages. As a result, all the outcomes should be considered when modeling this new technology. ​

Recent developments in wireless communication inflate a new area of research named as Wireless Body Area Networks. WBANs enhance the concept of virtual hospital with the help of cloud computing (CC) technology. Still numerous technical challenges could be found to integrate Cloud Computing (CC) and WBANs. From networking perspective, Software Defined Networking (SDN) becomes popular for its centralized nature to manage complex network infrastructure. In this paper, the concept of cloud enabled virtual hospital architecture based on software defined networking has been proposed and studied for wireless body area networks. This paper highlights a new, simplified architecture for virtual hospital concepts harnessing the benefits of software defined networking to mitigate the complexity of cloud architecture and its integration with WBAN.

eduCRATE is a complex project proposal which aims to develop a virtual learning environment offering interactive digital content through original and integrated solutions using cloud computing, complex multimedia systems in virtual space and personalized design with avatars. Compared to existing similar products the project brings the novelty of using languages for medical guides in order to ensure a maximum of flexibility. The Virtual Hospital simulations will create interactive clinical scenarios for which students will find solutions for positive diagnosis and therapeutic management. The solution based on cloud computing and immersive multimedia is an attractive option in education because is economical and it matches the current working style of the young generation to whom it addresses. [ABSTRACT FROM AUTHOR]

Abstract: We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of ‘patient’ and the role of ‘physician’. As a ‘physician’ the student operates the medical devices to clinically assess ‘patient’ colleagues and records all results in an electronic ‘patient’ record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated. The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students’ transition from preclinical to clinical subjects. [Copyright &y& Elsevier]

The article presents the results of surveys carried out in health care organizations on Polish territory. The aim of this study was to identify the degree of preparation of these organizations to implement modern information systems based on the mechanisms of knowledge management. System this kind is currently performed by the Institute of Engineering of Production at Silesian University of Technology to improve working conditions in healthcare organizations in frame of research project, which is finansed by the National Center for Research and Development. In frame of surveys it has been analyzed both existing infrastructure of IT solutions,as well as attitudes of medical personnel in the field of gaining a new knowledge. In frame of surveys it has been analyzed both existing infrastructure of IT solutions, as well as attitudes of medical personnel in the field of gaining a new knowledge. Wherein, in particular, it was subjected to analysis of the knowledge related to working conditions. The results showed weaknesses in the use of modern systems based on ICT, as well as they showed relatively high potential for prognosis of the possibility of implementing such systems without having to build from the base new infrastructure. [ABSTRACT FROM AUTHOR]

Over the last decade various international Information and Communications Technology networks have been created for a global access to high-level medical care. OP 2000 has designed and validated the high-end interactive video communication system WinVicos especially for telemedical applications, training of the physician in a distributed environment, teleconsultation and second opinion. WinVicos is operated on a workstation (WoTeSa) using standard hardware components and offers a superior image quality at a moderate transmission bandwidth of up to 2 Mbps. WoTeSa / WinVicos have been applied for IP-based communication in different satellite-based telemedical networks. In the DELTASS-project a disaster scenario was analysed and an appropriate telecommunication system for effective rescue measures for the victims was set up and evaluated. In the MEDASHIP project an integrated system for telemedical services (teleconsultation, teleelectro-cardiography, telesonography) on board of cruise ships and ferries has been set up. EMISPHER offers an equal access for most of the countries of the Euro-Mediterranean area to on-line services for health care in the required quality of service. E-learning applications, real-time telemedicine and shared management of medical assistance have been realized. The innovative developments in ICT with the aim of realizing a ubiquitous access to medical resources for everyone at any time and anywhere (u-Health) bear the risk of creating and amplifying a digital divide in the world. Therefore we have analyzed how the objective needs of the heterogeneous partners can be joined with the result that there is a need for real integration of the various platforms and services. A virtual combination of applications serves as the basic idea for the Virtual Hospital. The development of virtual hospitals and digital medicine helps to bridge the digital divide between different regions of the world and enables equal access to high-level medical care. Pre-operative planning, intra-operative navigation and minimally-invasive surgery require a digital and virtual environment supporting the perception of the physician. As data and computing resources in a virtual hospital are distributed over many sites the concept of the Grid should be integrated with other communication networks and platforms. [ABSTRACT FROM AUTHOR]

Summary: A successful problem based learning approach to the education of health care professionals is dependent upon facilitators having access to a bank of authentic scenario. The assertion made here is that methods employed to build scenario, containing problems that act as triggers for learning, are difficult to author and compel the facilitator to define the problems at the outset negating any need for the learner to engage in problem identification, a crucial skill for learners to acquire. The article explores several methods of building scenario that have the potential to offer a solution to the problem of problem pre-definition with the conclusion that they all have limitations and bring with them a new set of challenges for the facilitator. The article goes on to introduce Penfield Virtual Hospital (Penfield), a computer-based tool developed to address some of the challenges posed by scenario building particularly relating to problem pre-definition. [Copyright &y& Elsevier]

The development of virtual hospitals and digital medicine helps to bridge the digital divide between different regions of the world and enables equal access to high-level medical care. Pre-operative planning, intra-operative navigation and minimally-invasive surgery require a digital and virtual environment supporting the perception of the physician. As data and computing resources in a virtual hospital are distributed over many sites the concept of the Grid should be integrated with other communication networks and platforms. A promising approach is the implementation of service-oriented architectures for an invisible grid, hiding complexity for both application developers and end-users. Examples of promising medical applications of Grid technology are the real-time 3D-visualization and manipulation of patient data for individualized treatment planning and the creation of distributed intelligent databases of medical images. [ABSTRACT FROM AUTHOR]

The promise of telemedicine to enable equal access to high-level medical care can only be realised by the development of virtual hospitals, digital medicine and a bridging of the digital divide between the various regions of the world. For this, the concept of the Grid should be integrated with other communication networks and platforms. A promising approach is the implementation of service-oriented architectures for an invisible grid, hiding complexity for both application developers and end-users. Therefore integrated Grid Tools Suites for application programmers must be developed. Thus enhancing development and deployment of Grid applications can bring us closer to the simplicity of use that is desired for grid infrastructures not only within the medico-clinical field. [ABSTRACT FROM AUTHOR]

The Wharton School has been offering a senior nurse executive fellowship, sponsored by Johnson & Johnson, for 22 years. As the executive role has changed, the program has evolved. As more chief executive officers and chief operating officers come from the ranks of nursing, the program will continue to change to meet the needs of the future. [ABSTRACT FROM AUTHOR]