Details on Telemedicine

we can defineTelemedicine  as the use of telecommunications to provide medical information and services. It may be as simple as two health professionals discussing a case over the telephone, or as sophisticated as using satellite technology to broadcast a consultation between providers at facilities in two countries, using video conferencing equipment or robotic technology.

Telemedicine generally refers to the use of ICT for the delivery of clinical care

 

 Telemedicine is practiced on the basis of two concepts:

real time  which can also be called as (synchronous) and

store-and-forward which is called as (asynchronous)

Real time telemedicine could be as simple as a telephone call or as complex as robotic surgery. It requires the presence of both parties at the same time and a communications link between them that allows a real-time interaction to take place. Video-conferencing equipment is one of the most common forms of technologies used in synchronous telemedicine.

There are also peripheral devices which can be attached to computers or the video-conferencing equipment which can aid in an interactive examination.

For instance, a tele-otoscope allows a remote physician to 'see' inside a patient's ear; a tele-stethoscope allows the consulting remote physician to hear the patient's heartbeat.

Store-and-forward telemedicine involves acquiring medical data (like medical images, biosignals etc) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline. It does not require the presence of both parties at the same time.

Dermatology, radiology, and pathology are common specialties that are conducive to asynchronous telemedicine. A properly structured Medical Record preferably in electronic form should be a component of this transfer.

Teleradiology, the sending of x-rays, CT scans, or MRIs (store-and-forward images) is the most common application of telemedicine in use today. There are hundreds of medical centers, clinics, and individual physicians who use some form of teleradiology. Many radiologists are installing appropriate computer technology in their homes, so they can have images sent directly to them for diagnosis, instead of making an off-hours trip to a hospital or clinic.

Telemedicine is most beneficial for populations living in isolated communities and remote regions and is currently being applied in virtually all medical domains. Specialities that use telemedicine often use a "tele-" prefix; for example, telemedicine as applied by radiologists is called Teleradiology. Similarly telemedicine as applied by cardiologists is termed as telecardiology, etc.

Telemedicine is also useful as a communication tool between a general practitioner and a specialist available at a remote location

Telepathology is another common use of this technology. Images of pathology slides may be sent from one location to another for diagnostic consultation.

Dermatology is also a natural for store and forward technology (although practitioners are increasingly using interactive technology for dermatological exams). Digital images may be taken of skin conditions, and sent to a dermatologist for diagnosis.

The other widely used technology, two-way interactive television (IATV), is used when a 'face-to-face' consultation is necessary. The patient and sometimes their provider, or more commonly a nurse practitioner or telemedicine coordinator (or any combination of the three), are at the originating site. The specialist is at the referral site, most often at an urban medical center.

Video conferencing equipment at both locations allow a 'real-time' consultation to take place. The technology has decreased in price and complexity over the past five years, and many programs now use desktop video conferencing systems.

There are many configurations of an interactive consultation, but most typically it is from an urban-to-rural location. It means that the patient does not have to travel to an urban area to see a specialist, and in many cases, provides access to speciality care when none has been available previously.

Almost all specialities of medicine have been found to be conducive to this kind of consultation, including psychiatry, internal medicine, rehabilitation, cardiology, paediatrics, obstetrics and gynaecology and neurology.

There are also many peripheral devices which can be attached to computers which can aid in an interactive examination.

For instance, an tele-otoscope

 allows a physician to 'see' inside a patient's ear;

a tele-stethoscope allows the consulting physician to hear the patient's heartbeat.

Teleradiology is the ability to send radiographic images (x-rays) from one location to another. For this process to be implemented, three essential components are required, an image sending station, a transmission network, and a receiving / image review station.

The most typical implementation are two computers connected via Internet. The computer at the receiving end will need to have a high-quality display screen that has been tested and cleared for clinical purposes. 

Sometimes the receiving computer will have a printer so that images can be printed for convenience

The teleradiology process begins at the image sending station. The radiographic image and a modem or other connection are required for this first step. The image is scanned and then sent via the network connection to the receiving computer.