TELEMEDICINE & ITS APPLICATIONS

Unit I:

www.biomedikal.in Unit I Introduction

Definitions:

www.biomedikal.in 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.

Slide 3:

www.biomedikal.in 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

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www.biomedikal.in

Slide 5:

www.biomedikal.in Delhi Kolkatta Hyderabad Chennai Mumbai Chandigarh Jaipur Indore Lucknow Ludhiana Bhopal Kanpur Ahmedabad Baroda Goa Pune Nagpur CBE Erode Chenganoor Salem Madurai Thirunelvelli Ramanathapurar Trichy Bangalore Mysore Belgaum Davengere Anantapur Hampi Nellore Tirupathi Vijayawada Kakinada Vizag Ranchi Guwahati Siliguri Bilaspur Bhubaneshwar Jamshedpur Bhavnagar

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www.biomedikal.in 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:

www.biomedikal.in Historical Overview of Telemedicine Development in Regard to Used Technology Telegraphy and Telephony – used during American civil war to send casuality alists 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:

www.biomedikal.in Drivers of telemedicine and telecare Technological drivers Non technological drivers

Technological drivers:

www.biomedikal.in Technological drivers Computing and information technology Network and communication infrastructure Technology led society

Computing and information technology:

www.biomedikal.in 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

Network and telecommunication infrastructure:

www.biomedikal.in 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

Technology-led society:

www.biomedikal.in Technology-led society Aptitude to develop strategy on an expansive scale

Non technological drivers:

www.biomedikal.in 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

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www.biomedikal.in Healthcare provision for travellers - seamen - flights and astronauts - prevent unnecessary diversion to the ports

Military applications:

www.biomedikal.in Military applications NATO and UN troops face problems due to difficult disease pattern Mobile army vehicles Primetime III n/w ‘military medical internet’

Other drivers:

www.biomedikal.in Other drivers Home telecare Cost reduction Market development Health policy and strategy

Scope of telemedicine:

www.biomedikal.in Scope of telemedicine Types of telemedicine - tele consultation - tele education - tele monitoring - tele surgery

Tele-consultation :

www.biomedikal.in Tele-consultation Uses 35% of the telemedicine n/w Takes place b/n two or more carers without patient involvement, or one or more carers and the patient Video conferencing – realtime – to get interactive feed back Store and forward – used in teleradiology for the transmission of x-ray files at periods of low n/w traffic

Tele-consultation :

www.biomedikal.in Tele-consultation To extract maximum benefit from teleconsultation process, the following things are prerequisities 1. Agree on the purpose of teleconsultation - to diagnose a condition - to monitor a progress of treatment - to develop the skills of healthcare workers

Tele-consultation :

www.biomedikal.in Tele-consultation Establish the progress and content of the tele-consultations Ensure practitioners are trained in the use of the equipment Formalize the delegation of clinical responsibilities Decide on documentation

Tele-education:

www.biomedikal.in Tele-education Clinical education for teleconsultation - non-expert, patient and internet expert Academic study in the internet Public education link

Tele-education:

www.biomedikal.in Tele-education Participant applications 1. Consultants Teleconsultation/video conferencing 2. Surgeons Virtual conference on surgery 3. Health Online clinical audit professionals 4. Clinicians, nurses CME

Tele- monitoring:

www.biomedikal.in Tele- monitoring Tele monitoring is the use of tele commns. Link to gather routine or repeated data on a patient’s condition - patient can be monitored and reminded to t take medicine - Ultrasound image can be tramsmitted to a pediatrician etc.

Telesurgery:

www.biomedikal.in Telesurgery Assistance for surgery given via video. Conducted across atlantic in 2001 sep Use of robotic arms to carry out remote surgical procedures - accuracy - war areas

Benefits :

www.biomedikal.in 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:

www.biomedikal.in Benefits 3. Improved communications between carers - results of tests and images are readily transmitted - 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:

www.biomedikal.in 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

Contd.:

www.biomedikal.in Contd. Additional training needs Difficult protocol development Uncertain quality of health information Low rates of utilization.