Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve the patients' health status.
A visit with the doctor has evolved over the years. Originally doctors made house visits in order to evaluate the patient.
Dr visits then evolved into a mass production, whereby patients traveled to the doctor’s physical office to be evaluated. This enabled the doctor to see many patients in a single day due to the elimination of the doctor’s travel time. The patients in turn incurred travel time, time wasted in the waiting rooms, and time spent waiting in the patient rooms for the doctor or nurse to appear.
At times it can be difficult to see a doctor due to the limited number of appointments available. If a doctor could not provide a diagnosis, the patient would be sent to another doctor’s physical office to be evaluated.
Telemedicine is not intended to replace the doctor visits, but to supplement doctor visits. One major application is to obtain expert advice from all around the country or nation. With the development of telemedicine, experts can review x-rays, blood results, and various other test results via the computer and provide their input as to their opinions or diagnosis.
Diagnostics can be performed remotely for: Radiology Mental Health
Homebased Consultations can be performed through video conferencing.
Home Vital Signs Monitoring allows ECG, blood glucose, blood pressure, temperature, weight, and ultrasound measurements to be taken from home and sent to the doctor.
Saves money on travel for specialized care Allows patients in remote locations to get the opinion of a specialist (better access to care) Also allows different/regional medicine options to be available to a wider range of people (Ayurvedic, Traditional Chinese, etc) Telemedicine is convenient and requires less travel or time off from work
Assists people in isolated communities who cannot get to a doctor or hospital Supports local clinics, doctors and pharmacies (by allowing them a wider range of services) Allows participation in clinical trials for Rural communities
Increases efficiency / decreases medical errors Allows doctors to diagnose overseas patients without leaving the office Facilitates volunteer work in undeveloped countries Specialists can monitor several patients or hospitals at once Doctors can monitor patients’ diagnostics via cell (blood pressure, glucose, etc) Patients can see a local provider who can consult a specialist (or another doctor) via internet
High costs associated with start up and implementation Insurance plans may not support use of telemedicine Rural areas do not have internet connectivity
Lack of confidentiality/security concerns Slow acceptance of technology More difficult to monitor doctor licenses and ability
USA: Approximately 10 percent of the US population is covered under Medicare. However, it accounts for over one quarter of all medical expenditures.
Both Medicare and Tricare recipients can now use Telemedicine. According to the American Telemedicine Association, reimbursement to the health professional is the same as the current fee schedule.
USA: According to The New York Times, of the 3.7 million military retirees that have access to health insurance through their civilian employer or group, approximately two million of them stay on Tricare, the military's lifetime health insurance program.
The Defense Secretary, Robert M. Gates, has been making attempts to cut Pentagon spending and has considered the use of Telemedicine as a way to reduce the impact of the 10 million people eligible for benefits in the coming years.
INDIA PathoIndia is a virtual community for pathologists in India. The portal is hosted by University of Basel, Switzerland.University of Basel
AFRICA West African Doctors & Healthcare Professionals Network West African Doctors & Healthcare Professionals Network A virtual meeting place for doctors and other health-care professionals to share information and knowledge. Telemedicine Africa Telemedicine Africa A web based patient consultation and training service tailored to needs of local communities in Africa.
NEPAL HealthNet Nepal HealthNet Nepal The project’s main objective is to “overcome the isolation of health professionals by creating a network of people and organizations linked by appropriate, simple and inexpensive communication technology.”
Pakistan Creating awareness University collaboration Rawalpindi Medical College Agha Khan University National University of Science & Technology Approximately two hundred medical students were enrolled in the five-year "Elixir Internship Program" in order to learn Telemedicine, content building, web maintenance and how to carry out health related research. The progress and learnings from this venture was then relayed to top universities such as Stanford, University of California, Los Angeles and University of Southern California.
Telemedicine’s involvement in preventative care has taken a huge step forward. Home health care monitoring has been expanded through the use of smartphones. Speakers at the 2010 World Congress summit spoke of the importance of smartphones in telemedicine. Harry Wang, director of mobile and health research at Parks Associates noted in a PC World reports article that his firm believes more than 70 percent of Americans will have smartphones by 2015.
He noted that some hospitals already are using iPhones as glucose monitors and patients can see reduced expenses when conducting tests such as at-home sleep studies. Parks Associates, a Dallas-based research company, forecasts U.S. sales of wireless home-health technology to soar to $4.4 billion in 2013 from just $304 million this year, in part due to the federal stimulus money for health IT.
AMD provides monitoring devices and software.
Cisco uses HealthPresence, Telepresence, and WebEx to provide remote care in Argentina.
A and D Medical features a Connected Health product line including a wireless activity monitor.
The Bosch Health Buddy connects patients to their care providers and reduces hospital visits.
TMED provides an affordable solution with encrypted web based video conference and patient monitoring on a standard PC.
CARDIOCOM’s OMNIVISOR enables case or disease managers and clinicians to receive information about patients' daily vital signs and symptoms. BLOOD PRESSURE GLUCOMETER PEAK FLOW MEDICAL SCALE PULSE OXIMETER
GE –provides a pocket sized ultrasound imaging device.
ICUcare – Edoc provides a routine medical exam on wheels with video conferencing.
Intouch Health – Remote Presence removes barriers of time and distance. The RP7 robot provides virtual presence and allows direct connection to Class II medical devices to send data. Increases hospital capacity.
Cybernet Medical trends patient data and alerts a physician on their mobile device.
Socket – A handheld PDA for medical use includes a barcode reader and RFID reader to manage bedside drug delivery and patient records.
Logitech – HD technology can be used for speech therapy. Lifesize provides telepresence in a compact platform.
Welch Allyn – The EHR connectivity initiative makes their medical devices accessible to a universal standard for recording medical device data. Their products include vital signs monitors, cardio monitors, digital otoscopes.
Capsule – touchscreen data collection and connectivy platform. Enterprise Connectivity Solution for hospitals brings together any device with the hospital health information system.
Sites such as Cardiosmart allow you to track your vital signs.
My Mood Monitor lets you screen for depression and anxiety symptoms.
The myHalo system helps aging seniors stay in their own home longer by automatically detecting falls and signaling for help when needed. myHalo visualizes key vitals (heart rate, temperature, and ADLs) from an interactive 24/7 dashboard; and tracks compliance levels and quantifies physical activity.
Studies by the several agencies within the U.S. Department of Health and Human Services, private vendors and assessments by ATA of its membership place the number of existing telemedicine networks in the United States at roughly 200.
The impact of these programs can be felt 10 times over, as they link almost 2,000 medical institutions throughout the country. Of these programs, about 100 are actively providing patient care services on a daily basis while the others are primarily used for administrative or educational use.
Cost savings from Telemedicine can be considerable. British health officials have recently included the use of Telemedical technology as part of a $31.6 billion dollar cost- savings plan.
At a recent health IT conference, a speaker noted home monitoring-related savings through reduced hospital admissions, emergency care, and readmissions by almost $78.9 million. The conference’s focus surrounded empowering individuals to make better decisions about their own health, while eliminating industry jargon and long wait times.