1. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Chapter 4 Telemedicine

2. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telemedicine (defined)  Telemedicine uses computers and telecommunications lines to deliver health care at a distance  Telemedicine may use store-and- forward technology to transmit still images or interactive videoconferencing for real time consultation

3. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telemedicine (cont)  A doctor transmits the sounds of a child's heart beating to a physician 250 miles away. Courtesy: www.nasa.gov

4. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telemedicine  A doctor views a slide via video Courtesy: www.nasa.gov

5. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telemedicine Continues To Grow  The VA has adopted telehome care  More insurers cover it  Growing prison population Telemedicine has been used in prisons for years

6. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Bluetooth Technology  Bluetooth technology can connect various devices so that, for example, when the pacemaker senses a dangerous event, the cell phone automatically calls 911  Phone-based heart monitors are being used in Japan

7. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Subspecialties  Teleradiology  Telepathology  Teledermatology  Teleophthalmology  Telecardiology  Teleneurology, including telestroke and the treatment of epilepsy  Telehome care, using remote monitoring devices

8. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Teleradiology  Oldest use of telemedicine  Telecommunicating radiological images Can be store-and-forward Can be real-time

9. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telepathology  Viewing microscopic images at a distance on a monitor Store-and-forward Real-time

10. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Teledermatology and Teleophthalmology  The practice of dermatology over telecommunications networks Store-and-forward Interactive videoconferencing  Teleophthalmology Using telemedicine to study the eye

11. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telestroke  Telemedicine is particularly important when time is a consideration  Telestroke patients can be evaluated by experts miles away to see if they need tPA (a clot busting drug which needs to be administered within a few hours of a stroke)

12. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telecardiology  1960s—It became possible to transmit heart sounds accurately and to fax ECGs  1990s—Echocardiograms could be telecommunicated  Second opinions via telecardiology are one of the most common requests in telemedicine People come into rural emergency rooms with chest pains, and many ER doctors want an expert consultation

13. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Teleneurology  Teleneurology uses email and vidoconferencing, so that a neurologist can diagnose at a distance  Teleneurology is also making referrals using email  Video can be used to study gait

14. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telepsychiatry  Telepsychiatry is used in areas with few psychiatrists  It can be an effective treatment for some conditions  It is not appropriate for all conditions

15. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Remote Monitoring Devices  Remote monitoring devices make it possible for patients to be monitored at home from afar  New experimental devices embed sensors in wearable fabric

16. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telehome Care  Telehome care involves a link between the patient’s home and a hospital or central office that collects the data  Equipment is installed in the patient’s home

17. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telehome Care (cont)  The patient can telecommunicate vital signs to a nurse at a distant location, and can also speak to the nurse  Telehome care has been found to cut rehospitalizations, ER visits, and to reduce hospital stays

18. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telemedicine in Prisons  Cost effective  Enhances security  Improves medical care  Both inmates and prison officials appreciate it

19. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Other Uses of Telemedicine  Baby CareLink  RetCam to diagnose retinopathy of prematurity  Treatment of Alzheimer’s (using motion detectors to monitor patients)  In daycare  Tele-trauma in Vermont

20. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Other Uses of Telemedicine (cont)  Weight management  Pain management  Spinal cord injury  Podiatry  Teleoncology systems Help cancer patients avoid lengthy trips to the doctor and feel more secure because they have a 24-hour link to health care

21. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Other Uses of Telemedicine (cont)  SATELLIFE delivers information to health care workers in remote areas  Telenurses and doctors are using the eICU Smart Alerts ® to monitor intensive care patients from afar and send alerts to the ICU personnel  In July 2006, the FDA approved a wireless electronic capsule to help diagnose stomach disorders

22. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Telenursing  Telenursing Teletriage Telecommunication of health-related data Remote house call Monitoring of chronic disease

23. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Technical, Legal, Insurance, and Privacy Issues  An appropriate telecommunications infrastructure must be in place  In addition several issues need to be addressed such as: Licensing Medical liability Insurance Privacy concerns

24. Information Technology for the Health Professions, Third Edition Lillian Burke and Barbara Weill Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Image courtesy of NASA.gov