1. Telemedicine and Mobile Telemedicine Systems Vikas Singh 12/12/06

2. Telemedicine  “The use of advanced telecommunication and information technologies to exchange health information and provide health care services across geographic, time, social and cultural barriers”  It includes both, the clinical (diagnosis, treatment and medical records) and academic medicine (research, education and training).

3. The Goals of Telemedicine Systems  Increase the accessibility of and to professional caregivers  Increase the quality and continuity of care to patients  Increase the focus on preventive medicine through early intervention  Reduce the overall cost of healthcare  For education and training  For providing services to remote areas in case of natural calamities, disasters and military and space operations.  Remote monitoring

4. Primary Delivery Methods  Real time telemedicine (synchronous) or Two way interactive television (IATV)  Used in psychiatry, internal medicine, rehabilitation, cardiology, pediatrics, obstetrics and gynecology, neurology  Store and Forward  Most commonly used in radiology, pathology and dermatology

5. Telemedicine Categories  Telehome Home Health Care  Telepsychiatry  Teleradiology  General Telemedicine  Telecardiology  Telemedicine Consulting  Teledermatology  Emergency Telemedicine  Telepathology  Teledentistry  Telesurgery

6. Telemedicine Structure  Biosignal Acquisition Module: for biosignal acquisition through sensors and peripheral devices  Digital Camera: for digital image or video capturing  Processing Unit: comprised of computers of varying complexity  Communication Module: GSM, satellite, POTS modem, Internet, WAN, PAN, etc.

7. Mobile Telemedicine Systems Drivers rapid advances in wireless, and network technologies advances in communication and medical technologies The pervasiveness, cost effectiveness and availability of mobile phones (GSM and 3g networks) Availability and cost effectiveness of satellite communications

8. Mobile Telemedicine Systems Source: Ackerman, et al. Telemedicine Technology

9. Why use wireless technologies  Relatively cheap  Present everywhere  Extremely popular with general public  Can reach virtually everywhere  Growth in wireless and cellular technologies  To improve access, continuity and quality of care  Can be used for provision of health care services in rural areas, ambulance vehicles, ships, trains, airplanes, home monitoring and long term care

10. Wireless Technologies used in Mobile Telemedicine  GSM cellular phone networks – 2g, 2.5g and 3g networks, Bluetooth and RF technologies  PDA’s  Satellite Systems  WLAN  WiMAX  Home/Personal/Body Area Networks  Mobile ad-hoc networks or MANET’s

11. Information flow of the mobile telemedicine system Source: Xiao et al.

12. System Design Source: Husni, et al., & Jones et al.

13. Areas of use of mobile telemedicine  Ambulatory and emergency care  Home health care  Long term care  For provision of health care services in rural areas, ambulance vehicles, ships, trains & airplanes.  In all the other categories of telemedicine

14. Use in emergency care and home monitoring Source: Mandellos, et al.Source: Jasemian and Nielsen

15. Findings of its use in emergency services  The system did not intrude into the privacy of the patients or the paramedics  It was easy to use  It was adequate for conducting clinical examination  It conveyed critical clinical information

16. Barriers  Technological  Infrastructure planning and development  Telecommunication regulations  Reimbursement  Licensing and credentialing  Medical malpractice liability  Confidentiality

17. Conclusion  Makes specialty care more accessible to rural and medically underserved areas  Improves communication between providers  Educational to remote and consulting practitioners  High patient and provider satisfaction  Keeps local healthcare dollars in local community  Possibly improves process of care and quality of care

18. Conclusion  Reduced overall cost of healthcare  Telemedicine distance learning programme’s can address healthcare professional shortage  However the study, development and use of telemedicine is still emerging with the advent of new technologies (medical and information)  There are several barriers that needs to be removed to make telemedicine a model for “Pervasive Healthcare” and fulfill WHO’s goal of “Health For All’ by the year 2010.