WBRC Technology Update: TeleHealth System

A patient and his medical provider communicate via Video Technology Conferencing (VTC).

WBRC excitedly moves another step forward into applying technology for “providing the right care in the right place at the right time” to our veterans and active duty service members.

The VA initiative to increase access to care services for those living in rural and medically under-served areas is now being explored and developed at the WBRC for those with visual impairment and blind through the use of the “TeleHealth” programs.

Currently offered in established programs in TeleAudiology, TeleCardiology, Tele-SCI/D-Spinal Cord Injury/Disorder, and PolyTrauma Network (PTN) and others, the use of electronic devices such as computers, and videoconferencing, allows healthcare interventions, examinations and timely contact with providers for care of veterans in different locations.  These electronic devices can eliminate unnecessary travel to clinics or hospitals.

Many low vision clinics and providers offer electronic transmission of pictures of retinal examinations of a patient in one place to examination and diagnosis by an optometrist or ophthalmologist at a different location.  An expansion of application of this type of technology is now being developed for other care service needs of the visually impaired or blind related to visual diagnosis to maintain maximum independence and maximum self care management of the eye disorder in conjunction with other medical conditions such as diabetes, hypertension, and medication management.  Adaptive accessibility of  “TeleHealth “  programs is being explored for ease of use by the visually impaired or blind veteran.

WBRC is planning to incorporate their new TeleHealth system in a variety of ways such as including VIST coordinators and/or family members into treatment planning meetings, family training programs, post-discharge consults, and employee training to name a few.  If you have any ideas as to how the use of technology available in TeleHealth could help benefit you or those veterans you know who are visual impaired or blind, or if you want to learn more about “TeleHealth” contact WBRC Nurse Manager Richard Wing RN at richard.wing@va.gov or call WBRC 650-493-5000, select Menlo Park, then enter ext. 24627.

CLICK HERE to learn more about TeleHealth in the VA

Written by: Richard Wing, WBRC Nurse Manager

ALUMNUS FOCUS: John Martyn

Written By: Laura Koehler, WBRC Orientation and Mobility Instructor

Photo: WBRC Alumnus John Martyn

John Martyn, a former student of the WBRC, has taken his computer training to the next level.  His goal is to be an advocate working with leading software companies to help them redesign their software products to make them accessible for the JAWS user. 

So…what is a JAWS accessibility/scripting solution?  JAWS (Job Access With Speech) is a computer screen reader  program in Microsoft Windows that allows blind and visually impaired users to read the screen either with a text-to speech output or by a Refreshable Braille Display.  Most companies as well as the non-blind community are very unaware of this technology, how it works and most importantly that their products are not accessible to the JAWS user.  Scripting solutions (program redesigns) are required to make them accessible. 

Mr. Martyn has devoted a great deal of his time creating these JAWS scripting solutions, however, his goal is to continue to work with leading software companies to encourage them to redesign their products.  His website, doitblind.com, focuses on this mission and is showing leading software companies that it is profitable and equitable to provide accessibility.  Solutions of interest to the blind community are:

1. blindtunes.net greatly enhances capabilities for iTunes as well as makes it easy to manage your music library and purchase tracks for your iPod or iPhone.

2. rhapsodyblind.com opens up the world of online music and allows you full access to the popular music service Rhapsody.

3. Mr. Martyn also designed a site for the NFB that promotes the learning and reading of Braille.  The site should be up and running in March and can be accessed from doitblind.com.

Mr. Martyn was also recently a presenter at the CSUN Conference, demonstrating how his scripting solutions work for QuickBooks accounting software.  Congratulations, John, on your efforts towards making computer technology accessible for the blind!   

CLICK HERE to visit John's Website

CAT Skills: December 2011

Submitted by: Susan Marshall, WBRC Computer Access Technology (CAT) Instructor

Photo: Computer, Keyboard, and Mouse setup

As our former and future CATS (Computer Access Training Section) students can attest to, computer access training enables them to work, play, communicate and participate in activities that may not otherwise be accessible.  Like all good things, moderation is important because spending too much time logged on will result in tired eyes, headaches, neck pain and a host of other problems.  If you’re an avid computer user and want to avoid the pitfalls of extended computer use, the CATS team recommends that following:

Ø  Stretch your body and move extremities (stretch your hands, walk around, take a break and take a few deep breaths too).

Ø  Keep blinking.  It washes your eyes in naturally therapeutic tears.

Ø  Remember 20-20-20.  Every 20 minutes, spend 20 minutes looking at something 20 feet away, minimum. 

Ø  Get the right light.  Good lighting isn’t just flattering – it’s healthy for your eyes.  Keep bright overhead lighting to a minimum.  Desk lamps should be shining on the desk, not you.  Try to keep window light off to the side, rather than in front or behind you.  Use blinds and get a glare screen.  Position the computer to reduce reflections from windows or overhead lights.

Ø  Monitor your monitor.  Keep it at least 20 inches from your eyes.  Center should be about 4 to 6 inches below your eyes.  Also, make sure it’s big enough with just the right brightness and contrast.  Adjust the screen settings to where they are comfortable.

Ø  Wear those computer specs!  Your eye care specialist can prescribe a pair of glasses just for seeing the computer screen.  Wear the appropriate corrective lenses while at the computer.

Ø  Mind your typing.  Make sure your arms are at a 90 degree angle at your elbow to avoid strain on the median nerve.  Stretch your hands and arms.

CAT Skills: Browsing Websites and Forms with JAWS

Photo: Web page and Links List displayed using Insert + F7

 Website designers try to make websites visually appealing and easy to navigate, but often don’t take into account those utilizing accessible software, like JAWS (screen-reading software).  Additionally, there are some basic rules for Website design, but no real standards which again, can make navigation frustrating and time consuming.  To make Website and Form navigation more efficient and less frustrating, following are easy to use tips for JAWS users:

Quick and Easy Website Navigation

Ø  INSERT + F7 brings up a List of all Links on a current page.  The List of Links can be explored by using the Up and Down arrow keys.  Then, press the Enter key to activate the chosen link.  Additionally, using the first character in a Link, like C for Contacts, is a quick way to find the desired link (see example).

Ø  INSERT + F6 to display a list of all headings on the current page.  Likewise in the links list, use Up and Down arrow keys to explore the list and the ENTER key to jump to the beginning of the chosen heading.

Ø  INSERT+ F5 to display a list of all form fields on the current page.  Use the arrow keys to select an item and press ENTER to jump to that item.

Ø  INSERT + F9 to display a list of all frames/content on a current page.

Quick and Easy Table and Spreadsheet Navigation

Ø  ALT + CTRL + RIGHT or LEFT ARROW takes you from Column to Column, Cell to Cell or Item by Item. 

Ø  ALT + CTRL + UP or DOWN ARROW takes you from the Cell Above or Below in a Column or Cell.

Ø  CTRL + WINDOWS KEY + SHIFT + J returns to the previous cell.

o  These keyboard strokes are particularly helpful for navigating through Bank Statements, Telephone Bills, Bus and Train schedules or most anything in a table format.

CAT Skills: ZoomText

Photo of a ZoomText user adjusting
magnification on the ZoomText toolbar.

Featured this month are easy methods to

Increase or Decrease ZoomText for new or

seasoned ZoomText users.

1.  Go to the ZoomText Toolbar while clicking up or down on the Power Spin Box

2.  Use the ZoomText Keyboard Feature Keys + (plus) or – (minus) to increase or decrease the magnification

3.  Use the Hot Key:  ALT Key and Press the + (plus) key to increase the magnification or ALT Key and Press the – (minus) key to decrease the magnification

4.  Hold down the CLTR Key while scrolling the Mouse Wheel

Post Contributed by Susan Marshall, CAT Instructor

Introducing CAT Skills: Keyboard Shortcuts

Picture of a person's hand on a computer keyboard

CAT (Computer Access Training) Skills is a new feature on the WBRC Blog that offers tips, techniques, trouble-shooting ideas and answers to frequently asked questions to CAT graduates and other WBRC students utilizing accessible computer technology, like ZoomText, Guide, JAWS and Dragon.  Follow the WBRC Blog and look for the monthly CAT Skills.  Featured this month are everyday keyboard shortcuts for all computer users.  Stay tuned for tips on ZoomText.

Everyday Shortcut Key Commands

Ctrl C = Copy (copy selected text)

Ctrl X = Cut (cut selected text)

Ctrl V = Paste (paste selected text)

Ctrl Z = Undo (undo last command)  

Ctrl P = Print

Ctrl S = Save

ALT Tab = Toggle between running programs

ALT F4 = Close open windows or programs

Ctrl T = Opens a new Tab in Internet Explorer

Post contributed by Susan Marshall, CATs Instructor