1. Using Computers for Health Care: Telemedicine Developments

2. What is telemedicine? literally “medicine at a distance” integration of computers, telecommunications, information, and medical care using computer technology to improve delivery of health care to rural and underserved populations

3. Benefits of telemedicine better access to health care for the geographically or socially isolated lower costs for both hospital and patient fewer referrals to consultants improved medical education

4. What makes telemedicine possible? computer technology –digital imaging –videoconferencing –remote monitoring networking and telecommunications –local networks –Interne

5. Internet technology created in 1969 at UCLA by US Department of Defense (4 computers) expanded to include 50 research sites by 1972 interconnected with other private and public networks during 1970s and 1980s currently a privately run system

6. Internet technology World-Wide Web (WWW) –invented by Swiss physicists in 1989 –access improved through development of browsers (Mosaic, Netscape, Internet Explorer) –usefulness improved through development of search engines (Yahoo, Infoseek, Alta Vista) –growing in popularity (53.5 million US adults)

7. Taking advantage of technology for medical care medical informatics –computerized patient records (history, insurance claim processing) –integrated information management systems –expert systems for advice or warnings –on-line journals and research reports

8. Taking advantage of technology for medical care telemedicine –accessing or sharing records over distance –teleradiology –videoconferencing –home health monitoring

9. Is telemedicine feasible? early projects failed due to poor planning and lack of financial support new technology has renewed interest successful programs exist (see Hamit) –Texas –North Carolina –Georgia –Kansas

10. Non-technical obstacles to telemedicine development reluctance to adopt new technology FDA regulation of telemedicine networks as medical devices interstate licensing and credentials malpractice and liability (especially telecommunication providers) reimbursement policies

11. Technical obstacles to telemedicine development security and confidentiality concerns telecommunication regulation and costs speed of communication (especially in rural areas) reliability and accessibility of information on WWW

12. Web sites for exploration http://www.cs.uwyo.edu/~rex/telelab.html http://www.wmcnet.org/tele-med/telemed.htm http://www.fammed.washington.edu/telemed/ http://zeus.arc.nasa.gov/spacebridge.html http://www.nlm.nih.gov/research/visible/visible_h uman.html http://www.nnlm.nlm.nih.gov/netinfo/ http://www.jem.org