User satisfaction with allied health services delivered to residential facilities via videoconferencing

We have investigated the role of videoconferencing in allied health service provision to high-care clients in rural residential facilities. Videoconferencing equipment was set up at a rural aged-care facility and a metropolitan allied health centre; ISDN transmission at 384 kbit/s was used to link the equipment. Twelve residents were assessed by both videoconference and face to face across five allied health disciplines (a total of 120 assessments). User satisfaction was measured using questionnaires and focus groups. Face-to-face assessment took significantly longer than videoconferencing assessment. However, the mean satisfaction ratings for face-to-face assessments were higher than for videoconferencing and the majority of the staff preferred the face-to-face format. Videoconferencing was particularly useful for consultations and the initial stages of the assessment process. A number of issues relating to the videoconferencing equipment, to the environment in which assessments were performed and to the clients themselves need to be addressed in order for this form of service delivery to be effective.

The importance of setting and evaluating standards of telemedicine training

The importance of appropriate training in the use of videoconferencing equipment for clinical purposes is often underestimated when telemedicine projects are established. We developed a user training programme which was delivered via videoconferencing to a group of 130 nurses. Training was delivered on a one-to-one basis. A questionnaire was developed to evaluate user satisfaction and the effectiveness of training. One hundred and two fully completed questionnaires were returned (a 79% response rate). High levels of satisfaction were obtained but the level of user competence reached 100% only when training was supported by a training manual and at least weekly practice. Before establishing a telemedicine service, the following steps appear to be important: identify the required training competencies; deliver a 'hands on' training programme based on the required training competencies; back up the training programme with an instruction booklet; ensure that trainees have at least weekly practice; measure the level of user competence.

Farming Systems: Beyond Production Technologies for Dairy RD&E

The challenge of Research, Development and Extension (R,D&E) is to apply agricultural science to serve the real needs of production systems. The ideal is to have community partnerships involving a variety of stakeholders with equal representation, and a sharing in the design of R, D&E actions. R,D&E policy in Australia is stressing the participation of industry in new projects. The Dairy Research and Development Corporation (DRDC) in Australia, and the Brazilian Agricultural Research Corporation for Dairy (Embrapa Dairy), have developed initiatives to identify priorities for R,D&E design with participation of the industry. However, weaknesses in the methods have been identified. The present study describes the results of a strategy to involve a broader range of stakeholders in the identification of regional dairy industry needs. The findings show that overall communication, finance and marketing as the three major priorities of three study regions, meaning that primary needs for the industry are not in production technologies. This is an apparent contradiction with what some stakeholders considered valuable for dairy farms, which are pasture, genetics and nutrition technologies. The results reflect the large amount of research activity into production technology, and the relative success of R,D&E. However, it is necessary to consider issues beyond production technologies before developing R,D&E projects or presenting technologies.