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TELEMEDICINE

This document defines telemedicine and discusses its history and components. It provides 4 definitions of telemedicine from various medical organizations that emphasize using technology to provide healthcare across distances. The history section outlines milestones in telemedicine from the early 1900s to present day. It also describes the elements of a telemedicine network including the patient end with medical devices, the specialist end for receiving records and responding, and the communication link between the two. Overall, the document provides an overview of telemedicine, how it is defined, how it has evolved over time, and its basic network setup.

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100% found this document useful (1 vote)
461 views39 pages

TELEMEDICINE

This document defines telemedicine and discusses its history and components. It provides 4 definitions of telemedicine from various medical organizations that emphasize using technology to provide healthcare across distances. The history section outlines milestones in telemedicine from the early 1900s to present day. It also describes the elements of a telemedicine network including the patient end with medical devices, the specialist end for receiving records and responding, and the communication link between the two. Overall, the document provides an overview of telemedicine, how it is defined, how it has evolved over time, and its basic network setup.

Uploaded by

Valarmathi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 39

I.

THAMIZHSELVI
M.SC.,(N) I Yr
MTPG &RIHS
PUDUCHERRY
INTRODUCTION
.
3. DEFENITIONS:

3.1 According to WHO


“e-HEALTH/Telemedicine refers to the provision of health
care services by health professionals where distance is a
critical factor, using information and communication
technologies for the exchange of valid information of
diagnosis treatment and prevention of diseases and injuries
and for continuing education of health care providers as
well as research and evaluations aiming at advancing the
health of the individuals and communities”.

 
3.2 According to Dennis j. streveler:
“Telemedicine is defined as use of electronic signals
to transfer medical data (photographs, x-ray images,
audio, patient records, videoconferences, etc.) from
one site to another via the Internet, Intranets, PCs,
satellites, or videoconferencing telephone equipment
in order to provide health care services across
geographic, time, economic, social, and cultural
barriers.”
3.3. Medical dictionary:
“The use of medical information exchanged from
one site to another site via electronic
communications for the health and education of the
patient or healthcare provider and for the purpose
of improving patient care. Telemedicine includes
consultative,diagnostic,and treatment services”.

3.4. Encyclopedia:
“Using a videoconferencing link to a large
medical center in order that rural healthcare
facilities can perform diagnosis and treatment. A
specialist can monitor the patient remotely taking
cues from the general practitioner or nurse who is
actually examine the patient”.
4. HISTORY OF TELEMEDICINE:

1906: ECG Transmission:


Einthoven, the father of electrocardiography , first
investigated on ECG transmission over  telephone lines .

1920s: Help for ships :


radios were used to link physicians standing watch at
shore stations to assist ships at sea that had medical
emergencies.

1955: Telepsychiatry
The Nebraska Psychiatric Institute was one of the first
facilities in the country to have closed-circuit television
in 1955. In 1971 the Nebraska Medical Center was linked
with the Omaha Veterans Administration Hospital and VA
facilities in two other towns.
1967: Massachusetts General Hospital:
This station was established in 1967 to provide
occupational health services to airport employees
and to deliver emergency care and medical
attention to travelers.
1970s:Satellitetelemedicine:
Via ATS-6 satellites. In these projects, paramedics
in remote Alaskan and Canadian villages were
linked with hospitals in distant towns or cities.
1980s:
The concept of telemedicine began at the health
sciences center in the late During its first trails
run, in June 1990, a routine post surgical follow-up
consultation suddenly turned into a life-saving
situation.
Between1994 and 1998:
Telemedicine units were installed in
several prisons.

IN 2010 :
Really it has own potential and it
extended in various medical field.
5. HEALTH&TECHNOLOGY :

In 21st–century cyber-infrastructure will likely evolve


into an electronic care health needs in an era of rapid
change and expanding knowledge.

5.1.1 Growth of tecnology:


IT has the potential to improve the quality safely and
efficiently of health care providers to collect, store,
retrieve and transfer information electronically. It has
the potential to exchange the quality in three major
areas of any health care. Personal health management,
Health care delivery and Public health. Technology
application contributes to get better quality of care.
Reduce medical errors and lessen administrative
5.1.2 THE INSTITUTE OF TELEMEDICINE:

The institute of medicine (IOM) has suggested the


use of information technologies and electronic medical
records (EMR) as a means of securing quality care,
efficiency and client safely (IOM,
2001).Recommendations from the IOM continues to be
integrated into health care system. One example of
health care’s transition to computer applications and
client date management is telemedicine.
GOALS OF TELEMEDICINE:

• There are three main goals for using telemedicine.


• Collect data
• Analyze and discuss
• Automatically respond.

TELEMEDICINE IS USED FOR AVARIETY OF


PURPOSE:
•Remote Consultation
•Second Opinion
•Interpretation Services
•Continuing education and exchange of clinical
information Home Care.
TYPES OF TELEMEDICINE:

Telemedicine is open to a variety of medical


specialties such as cardiology, pathology, neurology,
psychiatry, dermatology, oncology and practically
every other branch. It is also useful for emergency
care, home health care and distance education.
 TELEPSYCHIATRY:
The application of telemedicine to the field of
psychiatry.
TELEDENTISTRY:
The use of Information technology and
telecommunications for dental care.
TELERADIOLOGY:
The use of Information technology to send
radiographic images (x-rays, CT, MR, PET/CT,
SPECT/CT, MG, US…) from one location to another.
TELEPATHOLOGY:
Transmission and interpretation of tissue specimen
via remote telecommunication, generally for the
purpose of diagnosis or consultation.
TELENURSING:
Nurses who practice in rural and unreserved urban
areas will have more autonomy and provide higher
quality care when linked electronically with the
support services of a large medical center.
Delivery Mechanism:
Networked Programs:
Link tertiary care hospitals and clinics with outlying
clinics and community health centers in rural or
suburban areas. The links may use dedicated high-
speed lines or the internet for telecommunication links
between sites.
Point-To-Point Connections:
 Using private networks are used by hospitals
and clients that deliver services directly or contract
out specialty services to independent medical service
providers at ambulatory care sites. Radiology, mental
health and even intensive care services are being
provided under contract using telemedicine to deliver
the devices.
Primary or Specialty Care to the Home
Connections:
 Involves connecting primary care
providers, specialists and home health nurses
with patients over single line phone-video
systems for interactive clinical consultations.
Home to Monitoring Center:
 Links are used for cardiac,
pulmonary or fetal Monitoring, home care
and related services that provides care to
patients the home. Often normal phone lines
are used to communicate directly between
the patient and the center although some
systems use the internet.
Web-based-e-health patient service site:
 Provide direct consumer outreach and
services over the internet. Under
telemedicine, these include sites that
provide direct patient care.
TELEMEDICINE SERVICES:
 Specialist referral services:
Typically involves of a specialist assisting a general
practitioner in rendering a diagnosis. This may involve a
patient “seeing” a specialist over a live, remote consult or the
transmission of diagnostic images and/or video along with
patient data to a specialist for viewing later.
Patient consultations:
Using telecommunications to provide medical
data, this may include audio, still or live images, between
a patient and a health professional for use in rendering a
diagnosis and treatment plan. This might originate from a
remote clinic to a physician’s office using a direct
transmission link or may include communicating over the
web.
 Remote Patient Monitoring:
Uses devices to remotely collect and
send data to a monitoring station for
interpretation. Such “home telehealth”
applications might include a specific vital
sign, such as blood glucose or heart ECG
or a variety of indicators for homebound
patients.
Medical Education:
Provides continuing medical
education credits for health professionals
and special medical education seminars for
targeted groups in remote locations.
Consumer Medical and Health
Information:
Includes the use of
the internet for consumers to obtain
specialized health information and on-
line discussion groups to provide peer-
to-peer support.
Components of Telemedicine
 
IT Equipments

Medical Devices

Video Conferencing System

Telemedicine Software

Telecommunication Equipment

 
 
6. ELEMENTS OF TELEMEDICINE NETWORK:

 THE PATIENT END.

 THE SPECIALIST END.

 THE COMMUNICATION LINK.


PATIENT END :
The patient end has to prepare an electronic
file of the patient’s history and his radiological
and pathological reports . these reports
converted into an electronic record.
The patient end includes various medical
equipment like ECG, X-Ray/MRI , Scanner,
Ultrasound ect ., interfaced with a computer
which has the telemedicine software preparing
and transferining the patient file.
THE SPECILIST END:
The specialist end has to receive the patient file
and display the patient records satisfactorily on the
monitor in order to enable the specialist doctor make
a diagnosis and recommendation for the line of
treatment and send it back to the patient end.
The process of receiving the records, examining
and sending back the diagnosis and recommended
line of treatment can be done in an “offline” mode.
The Communication Link:
The Communication link is like a pipeline
connecting two sources of information. The speed
and quality of flow will depend upon the
“bandwidth” available. The link could be a simple
telephone line (providing 64 Kbps) Internet or ISDN
line (provides 128 or 384 Kbps) or fiber optic on
satellite link, depending upon requirement,
availability, operational acceptability generally a 384
Kbps connectivity is found acceptable. This is the
norm in many Telemedicine networks abroad.
Satellite based connectivity has the
advantage of being available in the remotest part of
the country. Normally, a Very Small Aperture
Terminal network (VSAT Network) would be used
to provide this connectivity.
TELEMEDICINE IN INDIA:

With the beginning of the 21st century, ISRO as a part


of application of space technology for Health care and
education, under GRAMSAT (Rural satellite) programmed,
in co-ordination with various system providers such as
INFINIUM, APOLLO, OTRI, BEL-VEPRO, TELEVITAL, etc.,
has initiated number of telemedicine.

ISRO's effort in telemedicine began with a small


demonstration . The first ISRO telemedicine network was
established in the year 2000 consisting of only 5 nodes
with Bangalore and Kolkata as super specialist end
hospitals and Chamarajanagar, Saragur and Tripura as
patient end hospitals. After initial trials and
experimentations with different bandwidths and network
configuration .
TELEMEDICINE CENTERS IN INDIA :
EXAMPLES:
AIMS HOSPITAL.(New delhi)
ARVIND EYE HOSPITAL(chennai)
BENEFITS OF TELEMEDICINE:
Reduce the travel costs of specialists.
Reduce the travel costs of patients.
Saves hospital accommodation of patients who can be treated
remotely.
Saves hospital processing costs of patients who can be
treated remotely.
Offers opportunity for second opinion
Reduces waiting time.
Video conferencing also opens up new possibilities for
continuing education training for isolated, rural health
practitioners.
Coverall health care management.
Coverall health care management.
Improved teaching and learning possibilities and
opportunities.
Facilities decentralization.
Promote maximization of scare central resources.
ROLE OF NURSES IN TELEMEDICINE :

 Rapid advances in technology may have the


potential to deteriorate the nurse-client relationship;
the nurse must be proactive and implement
interventions that maintain the quality of these
relationships with allocated resources that facilitate
positive treatment outcomes.

 The must adapted with newer technologies that will


enhanced training opportunities in emergency
department.
The telemedicine nurse becomes the expert examiner
of record who was interacting from the medical center
hub and provided opportunity for beer evaluation.
There is need for creating greater awareness
and acceptability amongst the medical fraternity
and to introduce telemedicine as an area of
education and training.

Broad roles, responsibilities and practices of


telemedicine nurses should be identified and a
baseline be established for future research in
telenursing. Despite growing interest in
telemedicine as a health delivery system,
explorations on the contributions of nurses and
their potential in telemedicine.
TELEMEDICINE PRACTICES:
 Computer influence every sphere of human
activity and bring in many changes in industry,
social science, law, and even in arts, music and
painting.
 Telemedicine covers a growing number of
medical specialties such as:
•Cardiology,Home Care
•Emergency Care
•Surgery
•Dermatology
•Oncology
•Pathology
•Ophthalmology
•Hematology
•ENT
•Nephrology
•Prehospital Care.
 
ETHICAL AND LEGAL ASPECTS OF
TELEMEDICINE:

CONFIDENTIALITY:

The American Nurses Association (ANA) has been


concerned about this issue for some time. In1995, the
House of Delegates of the organization approved a
policy called “privacy and confidentiality Related to
Access to Electronic Data”. In 1998, the Board of
Directors endorsed the “Core Principles of Telehealth,”
intended to regulate telecommunication technologies
used to provide long-distance care, education, and
patient data.
PRESENTING ISSUES ABOUT
TELEMEDICINE:

Publicity of telemedicine technology.


Network contracts and regulatory matters.
Complexity in cross border networking and
connection.
Financing for networking and acquisitions of
services
Need to develop software solutions in
health care.
Mode and payment options.
Development of internet protocol.
Issues related to confidentiality.
Need for Telemedicine Policy and regularly
environment.
 
FUTURE CHALLENGES ABOUT TELEMEDICINE:

20.1. SYSTEM DESIGN:

20.2. EXPENSE:

20.3. LEGAL ISSUES:

20.4. EFFECTS ON NURSING PRACTICE:

20.5. EDUCATION AND CONFERENCING:

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