TELEMEDICINE

Telemedicine provides medical services through the assistance of telecommunications. Telemedicine does not completely replace medical expertise, but it is critical to providing quality and efficient health care services.

Telemedicine is a rapidly growing part of the medical information management market and is one of the largest and fastest growing segments of the healthcare device industry. The expected revenue by the end of 2000 is $21 billion. In the United States, more than 60 percent of federal telemedicine projects were initiated since 1998. The concept of telemedicine exploits much of the state-of-the-art technology available, especially if it is combined with the growth of the Internet and World Wide Web (WWW).† 3G networks will fur
ther guarantee a wireless extension of Internet-based services and technologies. By reducing the time spent in copying, sending, and archiving medical information, the cost of administration and insurance claim processing is reduced. Mobile medicine will enable healthcare workers to receive supply-ondemand content in a mobile environment.

Some of the advanced telemedicine applications include telecardiology, teleradiology, and telepsychiatry. Telecardiology services incorporate transmission of ECG data, echocardiograms, heart sounds and murmurs, and cardiology images, and can be performed in both store-and-forward and interactive media. Teleradiology is the most widely adopted of all telemedicine applications. Clinical radiology requires prompt, near real-time transmission of still-frame images, but may also demand live or full-motion video image communication and display. Telepsychiatry allows psychiatric care to be conducted at a distance to provide care more frequently to patients in outlying areas.

Telemedicine applications usually encompass computer, video, and telecommunications technologies—each with its own role to play in the acquisition, transport, and display of medical information. Some of the key areas related to telemedicine include patient record management and mobile clinics.

PATIENT RECORD MANAGEMENT. Patient record management involves the storage and retrieval of medical information related to a specific person. Patient information may be gathered manually (such as an X-ray on film) or electronically (such as a patient history data record). Patient record management via telemedicine involves converting nonelectronic forms of information (such as the X-ray) into electronic forms (data files) and managing these data files to integrate data, voice, digitized images, or video. These files are stored in a computer and can be transmitted to workstations at a medical center, physician’s office, or other site equipped to manage the telemedicine information request. Rapidly transporting image data and diagnoses between clinicians and medical doctors can add substantially to improved patient care.

MOBILE CLINICS. Mobile clinics are transportable facilities where health care specialists can treat patients. Using wireless high-resolution video conferencing, mobile clinics in the form of buses or vans can travel throughout rural areas with clinical technicians bringing hospital-type facilities to remote areas. The clinical technician coordinates communications with medical experts via wireless video conferencing consultations.

These telemedicine videoconference facilities allow hospital-based physicians to view patient wounds from a live videoimage. The traditional method requires visiting nurses to take Polaroid photographs of wounds and forward them to physicians for review. From the snapshot, the physician assesses how the wound is progressing and determines whether changes in medication or treatment are needed. Using mobile medicine, visiting nurses dial the physician, forward the image in real-time, and facilitate interaction between patients and hospital-based providers. Images can be captured and stored in an electronic medical record. The technology can help reduce the cost of continuing inappropriate therapy and shorten the time between data collection and decision making.