The REmote Patient Education in a Telemedicine Environment Architecture (REPETE).

The objective of the study was to develop and implement an architecture for remote training that can be used in the narrowband home telemedicine environment. A remote training architecture, the REmote Patient Education in a Telemedicine Environment (REPETE) architecture, using a remote control protocol (RCP) was developed. A set of design criteria was specified. The developed architecture was integrated into the IDEATel home telemedicine unit (HTU) and evaluated against these design criteria using a combination of technical and expert evaluations. Technical evaluation of the architecture demonstrated that remote cursor movements and positioning displayed on the HTU were smooth and effectively real-time. The trainers were able to observe within approximately 2 seconds lag what the patient sees on their HTU screen. Evaluation of the architecture by experts was favorable. Responses to a Likert scale questionnaire regarding audio quality and remote control performance indicated that the expert evaluators thought that the audio quality and remote control performance were adequate for remote training. All evaluators strongly agreed that the system would be useful for training patients. The REPETE architecture supports basic training needs over a narrowband dial-up connection. We were able to maintain an audio chat simultaneously with performing a remote training session, while maintaining both acceptable audio quality and remote control performance. The RCP provides a mechanism to provide training without requiring a trainer to go to the patient's home and effectively supports deictic referencing to on screen objects.