Telemedicine In Today’s
Healthcare Arena
Jason M. Kramer, RN PHRN
Objectives
• Define telemedicine
• Define the types of telemedicine
• Describe current telemedicine
practices
• Define the hardware used in
telemedicine
• Define the software used in
telemedicine
• Evaluate the usability of
software
Objectives
• Define Information Systems
• Discuss Advantages of Telemedicine
• Discuss Disadvantages of
Telemedicine
• Discuss Ethical and Legal Issues of
Telemedicine
Objectives
• Discuss Informatics Competencies
• Discuss Functions and
Responsibilities of Informatics Nurses
What is Telemedicine
• Telemedicine
– To communicate with patients outside of the
hospital/clinic.
– For health care providers to communicate with
health care providers.
– To monitor patients while they are at home.
Definition of Telemedicine
• “The use of medical information
exchanged from one site to
another via electronic
communication to improve
patients’ health status.”
(American Telemedicine Association, n.d., Telemedicine
Defined Section ¶ 1)
Types of Telemedicine
• Real Time – Synchronous
• Store and Forward – Asynchronous
Current Telemedicine Practices
• Radiology – Accessing and Reading Films from a
remote site.
• Cardiology – Interrogation of Pacemakers and
AICD’s in a patients home by telephone.
• Uploading of vital signs from home to a remote
monitoring center
• Diabetes – Linking of Glucometers with Insulin
Pumps and Physician offices.
• EMS – Video conferencing with Physicians from the
field.
Hardware in Telemedicine
• Personal Computer
• Communication Link
• Digital or Video Camera
• Printer/Scanner
• Video Conferencing System
(EDT, n.d.)
“Medtronic” Hardware Information
• Personal
Computer
• Insulin Pump
• Glucometer
• Continuous
Glucose Monitor
(Untitled Photograph, n.d.)
Telemedicine Software
• CareLink Software
• CapSure Software
• AMD Software Solutions
“Medtronic” Software Information
• “CareLink”
software for
Medtronic Insulin
Pumps
– Effects of Insulin
– Charting
– Patterns
(Untitled Photo, n.d.)
Usability of “Medtronic” Software
• Insulin Pump Software
• Computer Software Carelink
Information Systems
• An information system is a collection of
methods, practices, algorithms and
methodologies that transforms data
into information and knowledge
desired by, and useful for, individual
and group users in organizations and
other entities.
• (“Learn more about”, n.d. What
is an Information System ¶ 1)
Information Systems
• Information that is collected and stored
– Lists of customers/patients
– Vital Signs
– Physician documentation
• The entire electronic health record system
Medtronic Information System
• Type of System
– Special Purpose/Clinical
• Users
– Patients
– Physicians
– Nurse Practitioners and Physician assistants
• Use
– Diagnose
– Document
Medtronic Information System
• Configuration
– Local Area Network
– Mainframe
• Data Standards
– Health Care Informatics Standards Planning Committee
Advantages of Telemedicine
• Improved Access
• Cost Effectiveness
• Patient Demand
Disadvantages of Telemedicine
• Legal Issues
• Liability
• Reimbursement
• Physicians/Patients
Legal/Ethical Issues of Telemedicine
• Interstate vs. Intrastate
• Licensure
• Accreditation
Legal/Ethical Issues of Telemedicine (cont.)
• Reimbursement
• Professional Liability Insurance
• Privacy Issues
Informatics Competencies
• Beginning Nurse
– To Communicate with other systems
• Access Data
• Upload and Download
– Use Computerized Monitoring
System
Informatics Competencies
• Experienced Nurse
– Apply Monitoring System
Appropriately
– Perform Basic Trouble Shooting
Functions/Responsibilities of Informatics
Nurse Specialist (INS)
• Informatics Nurse Specialists
– Devising strategies for installing
applications/systems
– Applying installation tools during implementation
– Managing the installation process
– Developing testing, implementation, conversion,
and backup plans
– Assisting in the resolution of basic software
problems
• (Starren, Tsai, Bakken, Aidala & Morin,
2005)
Functions/Responsibilities of Informatics
Nurse Specialist (INS)
– Performing complex troubleshooting in
applications
– Producing short- and long-term training plans
– Producing training manuals and operating
manuals
– Delivering user training programs
– Evaluating user training programs
• (Starren, Tsai, Bakken, Aidala & Morin,
2005)
Summary
• What is Telemedicine
• Real time –Synchronous
• Store and Forward – Asynchronous
• Usage
• Components
• Informatics Systems
Summary (Cont.)
• Advantages
• Disadvantages
• Informatics Competencies
• Functions and Responsibilities of the
Informatics Nurse Specialist
Bibliography
• American Telemedicine Association.
(2010). Telemedicine Defined. Retrieved
September 11, 2010, from
http://www.americantelemed.org/i4a/pages/index.cf
m?pageid=3333
• Busey, J.C., & Michael, P. (2008, August).
Telehealth—opportunities and pitfalls . Journal of
the American Dietetic Association, 108(8),
Retrieved from
http://www.sciencedirect.com.ezaccess.libraries.ps
u.edu/science?_ob=ArticleURL&_udi=B758G4T25TH56&_user=209810&_coverDate=08%2F31%2F2008
&_rdoc=1&_fmt=high&_orig=search&_origin=searc
h&_sort=d&_docanchor=&view=c&_acct=C000014
439&_version=1&_urlVersion=0&_userid=209810&
md5=eeeac2f643fcf966299a06d441c983be&searc
htype=a
Bibliography (Cont.)
• CareLink Personal Therapy Management Software.
(n.d.). Insulin Pumps, CGM (Continuous Glucose
Monitoring), Minilink Transmitter, Paradigm Revel,
Diabetes Glucose sensors and meters | Medtronic
Diabetes | Formerly Minimed. Retrieved October 5,
2010, from
http://www.minimed.com/products/software/index.ht
ml
• Encounter Management Software Tools | AMD
Global Telemedicine. (n.d.). Telemedicine
Equipment & Telehealth Technology - AMD Global
Telemedicine. Retrieved October 5, 2010, from
http://amdtelemedicine.com/telemedicineequipment/encounter-managementsoftware/index.html
Bibliography (Cont.)
• Grady, D. (1999, October 22). Doctor at south pole
received medical help via video. The New York
Times, Retrieved from
http://www.nytimes.com/1999/10/22/us/doctor-atsouth-pole-received-medical-help-via-video.html
• HEALTH DATA STANDARDS: THE PLAYERS.
(n.d.). UW Faculty Web Server. Retrieved October
28, 2010, from
http://faculty.washington.edu/ocarroll/infrmatc/datab
ase/data/players.htm
Bibliography (Cont.)
• Learn More About Information Systems (IS). (n.d.).
UMBC An Honors University in Maryland. What is
an Information System. Retrieved November 11,
2010, from
http://www.is.umbc.edu/about_us/aboutIS.asp
• Medical Imaging Telemedicine Telehealth Store
and Forward. (n.d.). Global Telemedicine
Telehealth Medical Imaging Technology . Retrieved
October 5, 2010, from
http://www.globalmedia.com/telemedicine/capsure.
html
Bibliography (Cont.)
• Starren, J., Tsai, C., Bakken, S., Aidala, A., &
Morin, P. (2005, August 5). The role of nurses in
installing telehealth technology in the home.
Retrieved from
http://www.medscape.com/viewarticle/508913
• Telemedicine. (n.d.). Dr. Sachin Kale, MD.
(Pathology), Aurangabad, Maharashtra, India..
Retrieved October 5, 2010, from
http://sachinkale1.tripod.com/telemedicine.htm
Bibliography (Cont.)
• What is Telemedicine. (n.d.). Center for Rural
Health, University of North Dakota School of
Medicine and Health Sciences. Retrieved
November 16, 2010, from
ruralhealth.und.edu/pdf/whatistele.pdf
• What is Telemedicine and Telehealth?. (n.d.).
American Telemedicine Association. Retrieved
November 16, 2010, from
www.americantelemed.org/files/public/aboutteleme
dicine/What_Is_Telemedicine.pdf
Photographic Bibliography
• EDT (Credit given), Tempus IC System
[Photograph] retrieved October 5, 2010 from
http://www.esa.int/SPECIALS/Technology/SEM6O
OMO7EG_1.html#subhead2
• Untitled Photograph of Medtronic Insulin Pump and
Hardware. Retrieved October 5, 2010 from
http://www.minimed.com/products/
• Untitled Photograph of Medtronic CareLink USB
wireless upload device. Retrieved October 5, 2010
from
https://www.medtronicdiabetes.com/store/products/
details/PS-ALL/MMT-7305NA#