Automatic message handling for a national counselling service

An automatic email handling system (AutoRouter) was introduced at a national counselling service in Australia. In 2003, counsellors responded to a total of 7421 email messages. Over nine days in early May 2004 the administrator responsible for the management of the manual email counselling service recorded the time spent on managing email messages. The AutoRouter was then introduced. Since the implementation of the AutoRouter the administrator's management role has become redundant, an average of 12 h 5 min per week of staff time has been saved. There have been further savings in supervisor time. Counsellors were taking an average of 6.2 days to respond to email messages (n=4307), with an average delay of 1.2 days from the time counsellors wrote the email to when the email was sent. Thus the response was sent on average 7.4 days after receipt of the original client email message. A significant decrease in response time has been noted since implementation of the AutoRouter, with client responses now taking an average of 5.4 days, a decrease of 2.0 days. Automatic message handling appears to be a promising method of managing the administration of a steadily increasing email counselling service.

Trial of low-cost teledermatology in primary care

We examined the feasibility of a low-cost, store-and-forward teledermatology service for general practitioners (GPs) in regional Queensland. Digital pictures and a brief case history were transmitted by email. A service coordinator carried out quality control checks and then forwarded these email messages to a consultant dermatologist. On receiving a clinical response from the dermatologist, the service coordinator returned the message to the referring GP. The aim was to provide advice to rural Gps within one working day. Over six months, 63 referrals were processed by the teledermatology service, covering a wide range of dermatological conditions. In the majority of cases the referring doctors were able to treat the condition after receipt of email advice from the dermatologist; however, in 10 cases (16%) additional images or biopsy results were requested because image quality was inadequate. The average time between a referral being received and clinical advice being provided to the referring GPs was 46 hours. The number of referrals in the present study, 1.05 per month per site, was similar to that reported in other primary care studies. While the use of low-cost digital cameras and public email is feasible, there may be other issues, for example remuneration, which will militate against the widespread introduction of primary care teledermatology in Australia.

Evaluation of a pilot second-opinion child telepsychiatry service

A second-opinion child psychiatry service was piloted for six months in the northern-most two-thirds of Queensland. It provided specialist expertise by telehealth to local multidisciplinary teams of mental health staff. During the study period, 28 videoconferences were performed by the service: nine for administrative purposes, two for educational purposes, and 17 for direct and indirect clinical applications. The mean time between a referral being made and a consultation being performed was 4.7 days (range 1-13), A survey administered to referring and non-referring mental health workers showed that the major barriers to service implementation included the limited allied health applications that were offered, a perceived lack of communication during the implementation phase of the service, and the creation of a new referral network that did not conform to traditional referral patterns in the north of Queensland.

The immediate and long term effects of singing on the mood states of people with traumatic brain injury

Mood changes in four male participants with traumatic brain injury (TBI) were observed following their participation in a 15-session song-singing programme. An analysis of the song material was undertaken to categorise the songs according to the predominant mood they portrayed. Results showed significant differences between participants for all moods (p

Tailoring reveals information requirements: the case of anaesthesia alarms

We discuss the phenomenon of system tailoring in the context of data from an observational study of anaesthesia. We found that anaesthetists tailor their monitoring equipment so that the auditory alarms are more informative. However, the occurrence of tailoring by anaesthetists in the operating theatre was infrequent, even though the flexibility to tailor exists on many of the patient monitoring systems used in the study. We present an influence diagram to explain how alarm tailoring can increase situation awareness in the operating theatre but why factors inhibiting tailoring prevent widespread use. Extending the influence diagram, we discuss ways that more informative displays could achieve the results sought by anaesthetists when they tailor their alarm systems. In particular, we argue that we should improve our designs rather than simply provide more flexible tailoring systems. because users often find tailoring a complex task. We conclude that properly designed auditory displays may benefit anaesthetists in achieving greater patient situation awareness and that designers should consider carefully how factors promoting and inhibiting tailoring will affect the end-users' likelihood of conducting tailoring. (C) 2004 Elsevier B.V. All rights reserved.