In this blog, the highlights of my latest webinar on “Emergence of Telemedicine and its impact on healthcare industry” are discussed along with few examples. As you know, telemedicine is growing tremendously especially after COVID-19 pandemic, an outlook to its definitions and applications are essential during this time. Let’s walk through the highlights:
Definition of Telemedicine:
The term “TELE”, a prefix word comes from Greek where it has the meaning “FAR”. The Prefix Tele when attached to other root words refers to “reaching over a distance or carried out between two remote points through electronic transmissions.
Telemedicine literally means “healing at a distance”.
Simple definition: “Telemedicine is the practice of medicine using information and communication technologies (ICTs) such as the computers, the internet and cell phones to deliver care at a distance.
Standard definition by WHO:
“The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities”
Definition of Telehealth:
It is a broader term of use of technology for health and health related services including telemedicine.
It is defined as “The delivery and facilitation of health and health-related services including medical care, provider and patient education, health information services, and self-care via telecommunications and digital communication technologies.”
Differences between Telehealth and Telemedicine:
It refers to both clinical and non-clinical services.
- A public health app that alerts the public of a disease outbreak.
- A video-conferencing platform for medical education.
It refers to remote clinical services.
- A mobile app that lets physicians treat their patients remotely via video-chat.
- A software solution that lets primary care providers send patient photos of a rash or mole to a dermatologist at another location for quick diagnosis.
History of Telemedicine:
1900: Introduction of Telephone became the major tool of communication in the medical field.
1930: Radio was used for transferring medical information, particularly in remote areas like Alaska and Australia.
1940: First radiologic images were exchanged between two medical professionals located in different health Centers in Pennsylvania which were 24 miles apart from each other.
1959: The clinicians at the University of Nebraska set up two-way television to transmit video to medical students across campus from each other.
1967: A medical station at Boston’s Logan Airport was linked to Massachusetts General Hospital.
1970: Healthcare providers at Norfolk state hospital started using video conferencing equipment which allowed physician and patient in different physical locations to consult each other
1993: Founding of the American Telemedicine Association, a non-profit organization designed to promote and expand telehealth technology companies as a way of increasing patient access to care.
2001: ISRO started Telemedicine programme, connecting remote/rural/medical college hospitals and Mobile Units through the Indian satellites to major specialty hospitals in cities and towns.
2003: World’s first telerobotic surgical service was established between St. Joseph’s Hospital in Hamilton and North Bay General Hospital 400 km north of Hamilton.
Benefits of Telemedicine:
- Reduced overhead expenses.
- Additional revenue stream
- Less exposure to illness and infection
- Patient satisfaction
- Knowledge sharing
- Continuity of care
- Improved access to care
- Preventive care services
- Decreased rate of infection spread.
Disadvantages of Telemedicine:
- Privacy issues
- Technical glitches
- No Physical Examination possible
- Telemedicine Equipment and Technology
- Extensive training may be required.
It is also known as “live telemedicine” or synchronous telemedicine. It is a two-way interaction between the patient and healthcare provider using audio and visual telecommunications technology. The American Telemedicine Association (ATA) defines synchronous telemedicine as follows: “Interactive video connections that transmit information in both directions during the same time period.”
It is the rapid virtual examination of a suspected stroke patient, over the video call.
Behavioral Health professionals (Psychiatrists) can evaluate patients who are unable or unwilling to come to the office.
Store and forward (asynchronous transfer):
It is a method by which healthcare providers share patient medical information like lab reports, imaging studies, videos, and other records with a physician, radiologist, or specialist at another location. The ATA defines as the “Term describing store-and-forward transmission of medical images and/or data because the data transfer takes place over a period of time, and typically in separate time frames. The transmission typically does not take place simultaneously.
Radiology: Imaging studies taken at one location can be interpreted by a radiologist at another location.
Pathology: Image rich pathology data can be transmitted between distant locations for the purposes of diagnosis, education and research.
Dermatology: Primary care physicians can take digital photos of their patient’s skin lesions and forward the images to a dermatologist for review.
Ophthalmology: Eye screenings for diabetic retinopathy can be captured digitally by retinal cameras and transmitted to a specialist for review.
Remote patient monitoring (RPM):
It is also known as “Telemonitoring”. It utilizes medical devices to collect patient’s health data from the patient in one location and is then sent electronically to a healthcare professional for monitoring and review.
The standard build of RPM devices consists of 4 core components:
It transmits patient information (example: Heart rate)
Localized data storage:
Present at the patient site that receives information from the device.
It receives information from the patient site.
It is built to provide solutions and recommendations as a result of the collected data.
Altumview systems: Smart medical alert system to monitor the activity of seniors.
Baby scripts: A virtual maternity care platform that enables obstetrics providers to deliver a new model of prenatal and postpartum care.
CAM patch: P-wave-centric ambulatory cardiac monitor and arrhythmia-detection device that is placed on the center of the chest over the heart for optimum ECG signal collection for up to 14 days.
Mobile health: (mHealth)
Mobile Health or mHealth uses mobile communication devices as well as software applications to support healthcare. These devices include mobile phones (usually smartphones), tablet computers, mobile sensors and other devices that use cellular networks (3G or 4G), Wi-Fi or Bluetooth.
STOMP: Stop Smoking Over Mobile Phones – A text messaging smoking cessation support programme introduced in New Zealand.
Food Switch: A smartphone app to provide nutritional advice on foods and suggest healthier alternatives.
Safe pregnancy and Birth: A mobile app that contains a wealth of information about pregnancy and puerperium.
The Telemedicine system consists of an interface between:
Hardware: It consists of a computer, printer, scanner, videoconferencing equipment etc.
Software: It enables the acquisition of patient information (images, reports, films)
Communication channel: It eventually bridges two geographical locations to exchange information and enable teleconsultancy between two locations.
Telemedicine work models:
Networked connections (like high speed internet lines) are typically used to link remote health clinics to larger health facilities like metropolitan hospitals. According to the ATA, there are about 200 networked telemedicine programs in the U.S., granting telemedicine access to more than 3000 rural sites.
Point-to-point connections are used by hospitals and clinics to deliver services directly or to outsource their services to other independent medical providers. These connections are private, high-speed networks especially common for Telepsychiatry, Telecardiology, and urgent care services.
Monitoring center links:
It is a type of telemedicine connection that powers remote monitoring of patients. It consists of a digital connection between a patient’s house and a remote monitoring facility. Patient’s medical data can be measured at home and transmitted electronically to a distant medical monitoring facility. These links usually take the form of internet, SMS, or telephone connections. It is commonly used for monitoring of pulmonary, cardiac, or fetal medical data.
E-health patient services:
These services are websites that are used for direct patient care.
Smart Patients: The SmartPatients website is an online community for patients and families affected by a variety of illnesses.
Mayoclinic: Mayo Clinic is an American nonprofit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing. It is one of the leading medical centers of the United States.
Applications of Telemedicine:
More about the Telemedicine market and future of telehealth was also shared in the webinar.