Introduction to TELEMEDICINEIntroduction to TELEMEDICINE

Definitions• Tele- (from Greek: far, at a distance, remote)

• Telemedicine utilizes information and telecommunications technology to transfer medical information for diagnosis, therapy and education.

• Telehealth is the use of information and communication technologies to transfer healthcare information for the delivery of clinical, administrative and educational services

• Telecare utilizes information and communication technologies to transfer medical information for the diagnosis and therapy of patients in their place of domicile.

Telemedicine - Applications

Home Care

&

Ambulatory monitoring

Disease Management

Disaster Management

Continuing Medical Education

& Public Awareness

Disease Surveillance &

Program tracking

Remote Consultation &

Critical Care Monitoring

Telementored procedures/

Surgery - Robotics

Telemedicine

Second Opinion &

Complex Interpretations

Current Uses and Application of Telemedicine

Telemedicine use can be divided into three areas: 1.decision-making aids,2.remote sensing,3.collaborative arrangements for real-time management of patients at a distance.Decision-making aids: •The simplest application of telemedicine is the use of on-line computer databases in the clinical practice of medicine. Search engines list abstracts from selected texts and journals that address specific or cross-referenced topics. This is the oldest application of telemedicine.

•Use of search engines by non-medical persons has become more common.

•Easy access of detailed medical information to laypersons creates new opportunities for self-diagnosis, or misdiagnosis, by those seeking to escape the financial and time burdens of standard medical care.

DefinitionsRemote sensing:• Remote sensing involves the transmission of patient information

from one site to another.• This includes electrocardiographic (ECG) and digital x-ray data. • Remote sensing raises the issues of patient record confidentiality

and patient consent.

Collaborative real-time patient management:• This represents the most innovative category of telemedicine and is

the primary focus of this review.• Collaborative video management, or videoconferencing, allows a

remote practitioner to observe and discuss symptoms with a patient or another practitioner.

• Two-way workstations produce quality digital motion pictures across long distances.

• Equipment needs include a communications network and peripheral equipment, such as an electronic stethoscope, otoscope, ophthalmoscope, and dermoscope.

Current Uses and Application of Telemedicine

Fig: Collaborative real-time patient management

Delhi

Kolkatta

Hyderabad

Chennai

Mumbai

Chandigarh

Jaipur

Indore

Lucknow

Ludhiana

Bhopal

Kanpur

Ahmedabad

Baroda

Goa

Pune

Nagpur

CBEErode

Chenganoor Salem

Madurai

Thirunelvelli

RamanathapurarTrichy

Bangalore

Mysore

BelgaumDavengere

Anantapur

Hampi

Nellore

Tirupathi

Vijayawada

KakinadaVizag

Ranchi

Guwahati

Siliguri

Bilaspur

Bhubaneshwar Jamshedpur

Bhavnagar

Delhi (Super Specialty Hospital)Jaipur

Lucknow

Chandigarh (State Hospital)

Bhopal

VSAT Link 384 Kbps

PSTN Link 33.6Kbps

Leased Line 512 Kbps

Leased Line 2 Mbps

Kolkatta

Faridabad(District Hospital)

Ayodhya (PHC)

Historical Overview of Telemedicine Development in Regard to Used Technology

• Telegraphy and Telephony – used during American civil war to send casuality lists and order supplies -1840-1920

• Replaced by radio-medical services 1920-1950• Radio Communications• Television and video -1950s• Information technology (digital data transmission)

-1990

Drivers of telemedicine and telecare

• Technological drivers

• Non technological drivers

• Other drivers

Technological drivers

1. Computing and information technology

2. Network and communication infrastructure

3. Technology led society

1.Computing and information technology

• Important factors in the progress of telemedicine are

- falling equipment costs

- increased power on the computers

- easy to use

- increase in the reliability of equipents

2.Network and telecommunication infrastructure

• Internet

• Speed of communication increased due to optical communication

• Need of greater BW – asymmetric subscriber line

• Asynchronous transfer mode (ATM)

• Wireless and satellite technologies

3.Technology-led society

• Aptitude and attitude to develop strategy on an expansive scale

Non technological drivers

• Extension of access to health care services

- Extending health care access to individuals and communities who have limited access due to bad weather, war, no transport etc. with few healthcare providers.

• Healthcare provision for travellers

- seamen

- flights and astronauts

- prevent unnecessary diversion to the ports

Non technological drivers

Military applications

• The US military is on the forefront of telemedicine application.

• Telecommunication linkages between base hospitals and remote military outposts have existed for many years.

• Endoscopic surgical procedures, including laparoscopy, are performed through videoconferencing.

• Cutting-edge applications include the use of real-time battlefield imaging devices mounted on a soldier’s helmet. Also, sensors mounted on a soldier’s vest capture the radio transmission of ECG data from a fellow soldier’s leads from a distance of up to 8 feet.

Military applications

• In the future, ECG and skin sensors will allow battlefield tracking data, with communication of individual soldier location and physiologic information to base health care personnel.

Military applications

Other drivers

• Home telecare

• Cost reduction

• Market development

• Health policy and strategy

Scope of telemedicine

• Types of telemedicine

- tele consultation

- tele education

- tele monitoring

- tele surgery

Benefits

1.Better access to health care- reducing travel- time savings for the patient and

carer- faster access to care

2. Access to better health care- improvement in the quality of care- can get specialist advice when it is

not available locally.

Benefits

3. Improved communications between carers

- results of tests and images are readily transmitted

- referals/discharge letters made available without delay

4. Easier and better continuing education

5. Better access to information

6. Better resource utilization

7. Better costs

Limitations of telemedicine

• Poor patient- carer relationship• Poor relationship between healthcare professionals• Impersonal technology – technophobic people will

hesitate to use• Organizational disruption- fear that telemedicine

- will increase workload- is market than user driven

- fear of technological obsolescence-lack of skills and need to acquire them-lack of agreed standards

Limitations of telemedicine

• Additional training needs

• Difficult protocol development

• Uncertain quality of health information

• Low rates of utilization.

Activity..*

Name: Model/Prototype Presentation

Teams: 6 MI Groups

Rules:1. Use thermocol basement(not bigger than A2 size)

2. The whole set up of Telemedicine should be depicted.

3. Use your innovations.

4. Winner will be decided by an external judge.

5. Last date of submission 10.08.2012(Fri)-4:00pm

*Counted for internal assessment.*Counted for internal assessment.