1. Design of Health Technologies lecture 3 John Canny 9/07/05

2. Background Telemedicine has a role to play in most health care systems: In developed countries, for monitoring chronic conditions: AsthmaDiabetesHypertension Heart Problems Sleep Apnea (irregular breathing)

3. Monitoring For these conditions: AsthmaDiabetesHypertension Heart Problems Sleep Apnea (irregular breathing) Falls (for elders) Others? There are simple, off-the-shelf monitoring gadgets. Frequency of monitoring varies with the condition and the patient, from once a day to continuous.

4. In Developing Countries In the developing world, telemedicine has a potentially even larger role to play. Hospitals: Advanced medical expertise is concentrated in a few cities, and telemedicine can form a bridge between these and other hospitals – support exchange of specimens, test data, and results. The demands for imaging and data exchange require very fast connections – e.g. satellite networks in India, or other broadband.

5. In Developing Countries Villages Since access to hospitals and doctors is often extremely difficult, telemedicine can form a bridge between these institutions and individuals in remote villages. Since villagers lack both medical and communications infrastructure, a field practitioner (e.g. a nurse or “barefoot doctor”) performs the visit in person. Data and results make a round-trip to a hospital. The communication needs are much less demanding – a phone is adequate, or email, even with a significant latency.

6. Using Telemedicine Telemedicine can have a key role in patient quality-of-life. Patients with chronic conditions often feel isolated and disconnected from their friends. Psychological well-being (and important part of general health) takes a beating. The “Pebbles” system was developed to help mitigate children’s sense of isolation, and help them stay up to date with school work. Other systems have been developed to provide virtual environments for children to interact with friends and relatives (e.g. Microsoft’s “Hutchworld” for cancer patients).

7. Questions Think about friends or relatives with a chronic medical condition. Would they benefit from telemedical monitoring? Can you anticipate any adoption challenges for them? Think about your own experience with hospitals: What kind of social experience would have improved your sense of isolation?