The American Telemedicine Association defines Telemedicine as "the use of medical information exchanged from one site to another via electronic communications to improve patients' health status."
The term "telehealth", "e-health" and "telemedicine" are often used interchangeably, the difference being that telemedicine involves using information technology primarily for the delivery of clinical services while telehealth and e-health also include the provision of non-clinical healthcare services like tele-education and tele-training for continuing medical education, practice management, research and administration.
Telemedicine is practiced when medical services like health consultations, diagnoses, procedures, patient report analysis, monitoring and so on, are electronically provided by practitioners to patients based in remote locations using telemedicine technology and equipment.
Types of Telemedicine
There are three primary types of telemedicine – Store and Forward, Remote Monitoring and Two-way Real-time Telemedicine.
Store and Forward Telemedicine includes healthcare services for non-emergency situations that can be provided offline, without requiring the presence of the provider and the patient at the same time. It involves the remote patient passing on his medical data like medical history, EMR, scans, reports, past diagnoses etc to the provider who assesses his health status based on the given information and reverts accordingly without carrying out a personal, real-time examination of the patient.
Remote Monitoring includes a telemedical facility actively monitoring patients over remote locations using telemedicine equipment and devices. It is an effective way of monitoring vital signs like ECGs, blood glucose levels, respiratory rates etc for volatile health issues like cardiovascular diseases, asthma and diabetes that require constant care and vigilance.
Two-way Real-time Telemedicine provides consultations, diagnosis and treatment over real-time videoconferencing, live transmission of diagnostic images/videos, phone conversations and other synchronous interactive telemedicine technology where the practitioner and patient remotely connect and interact with each other at a given time with a local doctor as an intermediary.
Besides these, some facilities also provide emergency telemedicine and disaster restoration tele-support services.
Benefits of Telemedicine
Telemedicine services aim to replace or at least equal traditional clinic visits, face-to-face consultations and visiting nurses, save costs and provide better care in locations where the quality of healthcare is not up to the mark. So far, around 50 medical subspecialties have adopted telemedicine with radiology turning out to be a heavy user. Teleradiology is widely used to electronically transmit x-rays, CT scans and other images to remote providers for evaluation and assessment.
Other branches that have resorted to telemedicine to improve their quality, reach and accessibility are dermatology, ophthalmology, psychiatry, cardiology and pathology.
Telemedicine technology allows patients to avail of quality consultations, monitoring, electronic housecalls, testing, diagnosis and treatments from remote locations that may lack the required medical services, connecting patients and practitioners via an integrated, global healthcare system. With telemedicine, practitioners can provide improved diagnoses and better treatments due to comprehensive digital data that is available to them offline and over the web. Follow-ups and monitoring patients becomes easier and more efficient owing to automated active monitoring devices that provide continual and constant connectivity between the two parties. As for patients in remote or under-served areas, telemedicine gives them access to world-class medical services without having to travel or shift base. This not only helps them gain valuable medical advice and treatment from top medical specialists but also saves on their travel expenses, unnecessary hospital visits and in many cases, cost of medicines and expensive health facilities.
Equipment and Facilities Required for Telemedicine
A successful telemedicine program requires specialized telemedicine equipment and facilities. For seamless and uninterrupted delivery of remote medical services, medical devices, peripherals and software solutions supported by expert telemedicine professionals, customer care personnel and training staff must be incorporated within a compatible system that functions according to an effective, tested workflow model.
The following facilities and equipment are usually needed to provide telemedicine services:
- Tele-consultation rooms
- Patient engagement facilities like beds, scopes etc
- Desktops/ Laptops/ Tablet PCs
- Internet Connectivity and Broadband Devices, Routers
- Film Scanner
- Digital Camera
- Video Conferencing Kit
- Specialized Tele medicine software for your subspecialty
- Non-invasive pulse and blood pressure unit
- Digital ECG
- Digital Microscope
- Glucometer and Haemogram analyzer
- Mobile vans (in case of mobile or emergency telemedicine centres and ambulatory care sites)
Telemedicine Delivery Channels
Telemedicine services can be provided over four main channels:
1. Point-to-point telemedicine where patients and providers (hospitals, clinics) are connected over private networks directly or through an independent practitioner as an intermediary.
2. Patient is connected to a specialty care provider through tele-videoconferencing for a real time consultation over a home connection.
3. Active tele-monitoring for housebound patients over specialized tele-monitoring systems.
4. Direct web-based telemedicine services and patient-care.
Telemedicine Support in the USA
Despite its numerous benefits, telemedicine has a long way to go before it finds a viable place in the country’s mainstream medical system. The government supports the adoption of telemedicine with a number of incentives and federal grants. The American Telemedicine Association provides more information on federal funding for telemedicine at http://www.americantelemed.org/