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| Systems | Description of system | Advantage | Disadvantages |
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| The RuralHub Telepsych system [44] | Report on a geriatric telepsychiatry consultation service provided by a tertiary-care hospital to rural nursing homes located up to a few hours’ drive away.
It has been successfully used with a wide variety of diagnostic groups (such as patients with depression, posttraumatic stress disorder, panic disorder and/or agoraphobia, Alzheimer’s disease, schizophrenia, and other mental-health conditions). | (i) Patients show acceptance and adherence to a treatment regimen.
(ii) Telepsych is comparable to conventional treatment in outcomes and cost.
(iii) Overcomes the traditional therapy (face-to-face sessions), particularly when dealing with patients prone to violence or who are afraid of leaving home for treatment. | (i) It creates “an impersonal atmosphere.”
(ii) Is problematic for elderly patients with sensory impairments, for treating uncooperative or paranoid patients, and in emergency situation.
(iii) Telepsych does not have a collaborative online environment to support exchange of formal and informal information.
(iv) There is not involvement of users in the design and development stages of the system. |
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| Portable tele-assessment system [45] | Remote evaluation of the elbow joint with spasticity and contracture in patients with neurological disorders. Especially in patients with spasticity. | (i) Provided physical as well as audiovisual interaction between the clinician and the patient.
(ii) Saving time and costs involved in the rehabilitation.
(iii) Attractive to the patients since it was designed to be lowcost and portable.
(iv) Allows remote monitoring of a remote way the progression of physical treatment without missing the essential part—physical feel. | (i) The spasticity test is limited, because the doctor has to perform therapy exercises, burn for teaching, and the replay to be viewed by the patient.
(ii) There is not involvement of users in the design and development stages of the system. |
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| AUBADE system [46] | AUBADE is an integrated platform built for the affective assessment of individuals. The system performs the evaluation of the emotional state. | (i) It has an intelligent emotion recognition module and a facial animation module.
(ii) It has databases where the acquired signals along with the subject's animation videos are saved.
(iii) Is a multifunctional system that can be utilized in many different ways and in multiple application fields.
(iv) The AUBADE system consists of a multisensorial wearable, a data acquisition, and wireless communication module, a feature extraction module. | (i) The system's clinical application is based on the ability of supporting clinical diagnosis related to all the pathologies taking into account if the patient's capability to feel and express emotions is limited or totally absent.
(ii) Due to the fact that emotions vary from person to person, the system must be trained by using a variety of subjects and then by testing its performance; this implies an investment of time that often people and specialists do not have. |
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| Telemedical Interventional Monitoring in Heart Failure (TIM-HF) [47, 48] | Wireless Bluetooth system with a personal digital assistant (PDA) that performs automated encrypted transmission via mobile phone of electrocardiogram measurement, blood pressure measurement, and body weight.
The telemonitoring system consists, on the one hand, of portable home devices (ECG, and blood pressure measurement and body weight) connected to PDA via a local network.
On the other hand, a telemedical workstation with electronic patient record that is a web application with a graphical user interface browser so that incoming measurements generate events according to a set of medical prioritization rules to initiate a workflow-guided review process in the telemedical workstation and its further evaluation by medical professionals. | (i) Prevents hospitalizations by early detection of disease worsening followed by immediate intervention.
(ii) Home devices for ECG, body weight, blood pressure, and self-assessment measurement are used.
(iii) PDA has a touchscreen option for a scaled self-assessment.
(iv) A home emergency call system provides direct contact to health-care professionals.
(v) The medical system has been built as an open platform to integrate other home devices for monitoring such as diabetes, chronic obstructive pulmonary disease, anticoagulants, and implantable cardiac device information. | (i) Telemedical centers must operate around the clock every day of year because it requires immediate diagnosis and prompt treatment.
(ii) To ensure patient safety, it was required at least that 94% of the total system be available, including the mobile phone network.
(iii) Wireless technology is susceptible to faults. Besides there is not defined standards for secure wireless transmission of the data.
(iv) The volunteers that proved the system were younger than the anticipated chronic heart population. |
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| Heart failure case disease management program [49] | Is a care process that verifies the state of a patient illness throughout sending the information concerning his or her vital signs such as weight, systolic blood pressure, heart rate, dyspnoea, asthenia, edema, therapy changes, blood urea nitrogen, creatinine, sodium, potassium, and bilirubine to medical staff in order to support decision-making to prevent haemodynamic imbalance, to reinforce educational support, to optimize therapy, and to improve quality of life and outcomes.
The telemedical staff and patients use a touchpad or mobile phone at their home, after having dialed a toll-free number. Then, each parameter was entered in reply to question asked by a recorded voice and a confirmation was requested to each of them. | (i) The program uses a toll-free number.
(ii) The overall procedure is managed by an interactive voice response (IVR) system (Appel Electtronica Srl, Turin); therefore, the data transmission did not require operator support.
(iii) The daily telemonitoring activities typically began by listening vocal message and taking the appropriate actions.
(iv) Optimized therapy and continuous redefinition of the care process.
(v) Increases patient’s knowledge about management of illness, recognition of initial signs, and symptoms.
(vi) The tight relationship between health-care personnel and patients allows coaching in a way that the patient is simulated toward an activate participation in self-management of his or her illness. | Management effectiveness depends on the team management, the intensity of treatment, the parameters monitored, the standardization of managerial algorithms and the characteristics of the patients. |
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| eMental System* | Supports the rehabilitation of the elderly with cognitive impairment through promoting social integration. It provides a cognitive stimulation therapy to the patients, caregivers, and specialists. | (i) It manages automatically the degree of difficulty to suit the cognitive level of each patient.
(ii) Provides visual feedback to users’ tasks.
(iii) The therapy is performed in the comfort
(iv) of home.
(v) It promotes family to incorporate with patient rehabilitation.
(vi) Saving time and costs involved in rehabilitation. | |
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| e-Park system* | The detection of cognitive deterioration of person with Parkinson’s disease. By applying the PD-CRS test through Internet. | (i) Standardization and optimization in the application of the PD-CRS test.
(ii) Capture and execution of quasi-digital PD-CRS test.
(iii) The system automatically manages the patients and the time duration for each session.
(iv) Provides visual feedback of the test results. | The first version of the system is not depending on the limitations of the patients. |
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