1. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Chapter 4 Telemedicine

2. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Telemedicine Technologies Telemedicine uses telecommunications lines to deliver health care. Store-and-Forward Images are digitized and sent over telecommunications lines. Interactive Videoconferencing Real-time online communication, including audio and video.

3. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Subspecialties of Telemedicine-Teleradiology Oldest use of telemedicine. Uses store-and-forward technology to share radiological images over telecommunications lines. Image is digitized, stored, and transmitted. Can be combined with interactive videoconferencing in a full telemedical consultation.

4. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Telepathology Uses store-and-forward technology to share microscopic images over telecommunications lines Requires microscope, camera, and monitor and a connection to a telemedicine system.

5. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Teledermatology Teledermatology uses store-and-forward technology and videoconferencing to share images of skin disorders over telecommunications lines. Certain skin conditions are difficult to diagnose via teledermatology. Teledermatology reduces unnecessary visits to the doctor.

6. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Telestroke Telestroke uses a combination of store- and-forward and interactive videoconferencing to diagnose strokes quickly. Because time is of the essence in diagnosing stroke, telestroke programs save lives.

7. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Telecardiology Telecardiology uses a combination of store- and-forward and interactive videoconferencing to diagnose heart attacks. Used for second opinions. Used by rural emergency rooms for expert consultations for people who come in with chest pains.

8. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Telepsychiatry Used where distances make traditional therapy impractical. The simplest telepsychiatry programs use telephone therapy. More expensive and complex programs involve therapy using full interactive telecommunications with video and audio. Not appropriate for some illnesses (schizophrenia).

9. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Remote Monitoring Devices Telespirometry system for ashthmatic patients Portable fetal monitor Arrhythmia monitor Smart stretcher Distance monitoring of blood glucose levels Remote monitoring of cardiac patients

10. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Telehome care Use of remote monitoring devices Real-time virtual visits from visiting nurses via telecommunications equipment that can evaluate patient Useful in monitoring chronic illness Increases access to health care in rural areas

11. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Telemedicine in Prisons Telemedicine is used in many U.S. prison systems. Cuts costs Increases security Increases access to health care services

12. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Other Telemedicine Applications Baby CareLink links at-risk hospitalized infants with their families. Teledoctors in day care centers. Tele-trauma project that links trauma surgeons to hospital emergency rooms.

13. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 The Tele-nurse Teletriage Communication of health-related information Remote house call and monitoring of chronic diseases May put nurses in more autonomous positions

14. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Issues in Telemedicine Technical issues Necessity for dependable high-speed telecommunications lines. These lines are not yet in place in many areas.

15. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Issues in Telemedicine: Legal Health care practitioners are licensed by the states. Telemedicine practitioners practice across state lines. Some agreements are in place allowing practice across state lines. In some states, a license is required for a practitioner in another state who teleconsults from another state.

16. Information Technology for the Health Professions, 2/e By Lillian Burke and Barbara Weill ©2005 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458 Issues in Telemedicine Medical liability Who is liable for damages: the consulting doctor, the on-site doctor, the company maintaining the telecommunications lines, the companies that built the computer? Questions of liability have not yet been answered. Privacy There is no guarantee of the privacy of medical records.