TELEMEDICINE
PREPARED BY
SANGEETA SONI
“TELEMEDICINE PROVIDES
HEALTHCARE WHERE THERE IS
NONE AND
IMPROVES THE HEALTH CARE
WHERE THERE IS SOME”
Telemedicine

Means "distance healing“.

Derived from a Greek word "Tele" meaning "distance" and a Latin word
"mederi" meaning "to heal“.

Is not one specific technology but a way of providing healthcare services
at a distance using telecommunications technology, medical expertise &
computer science.

Telemedicine is the future of global healthcare.
Types of Telemedicine
Realtime (synchronous)
Store and Forward
(asynchronous)
Realtime (synchronous)

Could be as simple as a telephone call or as complex as robotic surgery.

Requires the presence of both parties at the same time.

E.g. : Video-conferencing equipment

There are also peripheral devices which can be attached to computers or
the video-conferencing equipment which can aid in an interactive
examination.

For instance, a tele-otoscope allows a remote physician to 'see' inside a
patient's ear; a tele-stethoscope allows the consulting remote physician to
hear the patient's heartbeat
Store and Forward (asynchronous)

Involves acquiring medical data (like medical images, biosignals etc) and then
transmitting this data to a doctor or medical specialist at a convenient time for
assessment offline.

Does not require the presence of both parties at the same time.

Dermatology, radiology, and pathology.

A properly structured Medical Record preferably in electronic form should be a
component of this transfer.

Teleradiology, the sending of x-rays, CT scans, or MRIs (store-and-forward
images).

Many radiologists are installing appropriate computer technology in their
homes, so they can have images sent directly to them for diagnosis, instead of
making an off-hours trip to a hospital or clinic.
Application Adopted

Most beneficial for populations living in isolated communities and remote
regions and is currently being applied in virtually all medical domains.

Use a "tele-" prefix;

Useful as a communication tool between a general practitioner and a
specialist available at a remote location.

Telepathology

Telecardiology

Teleradiology

Telesurgery

Teleopthalmology
Home Care
and
Ambulatory
Remote
Consultation
and Critical
Care
Monitoring
Disaster
Management
Telemedicine
Application
Telementored
Procedure/
Robotic
Surgery
Medical
Education
and Public
Awareness
Second
Opinion
Advantages of Telemedicine

Resource utilization

Early intervention

Avoids unnecessary transportation

Community based care

Medical education and research

Cost saving

Improved patient documentation

Increased range of care and education.
Resource Utilization

In India doctor population ratio is 1:15000 in comparison to 1:500 in developed nations,
and these doctors are not distributed equally.

80% Indian population lives in rural and semi urban areas.

Telemedicine can help in cost effective utilization of meager resources and of the same
time can decrease patient work load on few referral centers.
Early Intervention

There are factors that inhibit the continuity of care. Issues such as geographic location,
inclement weather, socioeconomic barriers.

Patient apathy are significant factors that delay and even prevent the specialty care.

By providing these primary cure sites with the ability to quickly access specialty
consultation services.

Patients are able to reap the benefits of early intervention while the health care system
maintains quality service and clinical efficiency.
Avoids Unnecessary transportation

Patient can discuss the issues on Video Conferencing with the consultant.

Even the vital parameters and be captured with the help of devices and sent to doctor.

Unnecessary referral and patient transport can be definitely avoided.
Community base Care

People like to receive high quality care in their local community.

This reduces travel time and related stresses associate with many referrals.
Medical Education and Research

When medical students are posted in rural area they can be linked to
medical college for grand rounds and they can also do case presentation
to teachers in medical colleges.

Physicians living in different parts of the world also use telemedicine in
collaborative research, they can also share data or can discuses current
trends.
Cost Saving

Reduced physician’s fees and cost of medicine.

Reduced visits to special hospitals.

Reduced travel expenses.
Telemedicine System
ACTUALLY WHAT HAPPENS DURING
A TELEMEDICINE PROGRAM?
Telemedicine Infrastructure

This will include minimum standards for all the hardware and software used
in a telemedicine system.

Under hardware it will include standards and guidelines for basic
telemedicine platform, servers, clinical devices, video conferencing
system, communication hardware and power support.

The software standards address operating system, telemedicine software,
and server software.
Hardware

Telemedicine platform:


Clinical devices


This will include minimum standards for all the clinical devices to be interfaced or integrated with the
telemedicine system, including performance specifications for devices measuring diagnostic
parameters, imaging devices, compression, and their safety requirements.
Video conferencing units


This will include minimum standards for type of platform to be used, processor/minimum speed, memory
requirements, interfaces, and peripherals.
This will include minimum standards for video conferencing system, including data rate, picture
resolution, frame rate, type of camera, audio quality etc.
Communication hardware

This will include minimum standards for various hardware used for interfacing the telemedicine system
with the communication network, including all types of terrestrial and satellite based networks.
Software

An operating system

Licensed telemedicine S/W with appropriate User Interface(UI)

Back-end Data Base with the mandatory tables/ fields (if applicable)
Connectivity

Options for telemedicine services

VSAT

PSTN

ISDN

Leased Line

Wireless LAN /WAN
Telemedicine Tools
Barriers of Telecommunication

Low or small bandwidth.

Neither telephone lines nor electricity in rural and remote areas.

Satellite transmission can help but it is very costly.

Unstable electricity supply.

Patient’s fear and unfamiliarity.

Financial unavailability.

Lack of basic amenities.

Literacy rate and diversity in languages.

Quality aspect.

Government support.
Need of Telemedicine in India

The advances in Medical science, biomedical engineering on one side
and Telecommunication and Information Technology on the other side are
offering wide opportunities for improved health care.

Health coverage to majority of our population is still a distant dream.

India is a vast country gifted with rich and ancient historic background
and geographically the nature has provided India with all the varieties like
the mountain regions like Ladakh, deserts, green planes and far flung
areas in the north east and offshore islands of Andaman’s and
Lakshadweep.

1 billion population.

Predominantly rural and distributed in distant geographical locations.
Need of Telemedicine in India

Further this is compounded by the following factors like:

High cost of health care and lack of investment for health care in rural areas.

Inadequate medical facilities in rural & inaccessible areas.

Problem of retaining doctors in rural areas where they are required to serve &
propagate widespread health awareness.
Need of Telemedicine in India

A recent survey by the Indian Medical society has found

75% of qualified consulting doctors practice in urban centers and

23% in semi urban areas and

only 2% from rural areas whereas majority of the patients come from rural
areas.

Hospital beds / 1000 people is 0.19 in rural and

2.2 in urban areas.

This calls for innovative methods of utilization of science and technology
for the benefit, of our society and telemedicine assumes a great
significance to revolutionize the health care system in India.
Available today
 mHealth
Wi-Fi Smart Scale
Bluetooth Stethoscope
Otoscope
Blood Glucose
Meter
Blood Pressure
Monitor
Digital
Thermometer
Remote Surgery
Robotics
Live Monitoring via
Cell Phones
At Home, at the Office,
on the Go, at a Kiosk
Thank You