Telemedicine in Medicine BT03.03  Definition: “The use of computers, the Internet, and other communication technologies to provide medical care to patients at a distance.”  Forms: –Voice –Data –Still images –Motion picture 1

Telemedicine  Includes: –Diagnoses –Patient monitoring –Treatments 2

Telemedicine  Telehealth: –Larger field that includes health- related education –public health research –health services administration 3

Telemedicine  Advantages: –Brings high quality medical care to anyone regardless of distance –Decreases patient wait time –Decreases patient travel time 4

Telemedicine  Teleradiology: Oldest form of telemedicine using computers and telecommunications. (send digital x-rays)  Interactive video conferencing: Conferencing that allows medical professionals and patients to consult in real- time, using telephones and video screens. (patient, Dr. and specialist can all meet at the same time from different places) 5

Telemedicine  Telepathology: Transmission of microscopic images over telecommunications lines allowing the pathologist to view images on a monitor instead of under a microscope. Equipment needed – microscope, camera and monitor  Telepsychiatry: Uses teleconferencing to deliver psychotherapy. May not be suitable for some types of mental illness. (does not always replace face-to-face counseling) 6

Telemedicine  Remote monitoring devices –Telespironmetry-  used for asthma patients  information transmitted over telephone lines to remote location –Arrhythmia monitoring  ECG telemetry that monitors a patient’s cardiac status and sends it to a remote location (EMS can send an ECG to the ER from the ambulance to get instructions from the ambulance to get instructions on advance care) on advance care) 7

Effectiveness of Telemedicine  Examining a patient at a distance is not the same as examining that patient face to face  In prisons, telemedicine has led to decreased costs and improved health care for inmates 8

Effectiveness of Telemedicine  Medical assistants at the remote sites may be useful  Small hospitals and clinics may find hardware costs prohibitive. It may limit their resources.  Research studies generally favorable for medical and cost effectiveness 9

Use of Telemedicine  Health care to the elderly (homebound)  Connect rural primary care physicians to urban specialists  Allow families of high-risk newborns to watch babies’ hospital care from home  Data can be transmitted from ambulance to ER  Patients with chronic illnesses can receive medication reminders at home 10

Issues in Telemedicine  Technical issues –appropriate telecommunications infrastructure must be in place  Some places lack telecommunication lines. –not available in some rural and urban areas –requires high bandwidth (cable modem) 11

Issues in Telemedicine  Insurance issues –insurance may not cover all telemedicine  Legal issues –licensing laws differ in each state –liability is not clear  Privacy issues –electronic medical record subject to misuse –HIPPA (Health Insurance Portability and Accountability Act of 1996) 12