Telemedicine Defined • Diagnosis, consultation, treatment, education and the transfer of medical data using interactive audiovisual and data communications • Use of electronic communication and information technologies to provide or support clinical care at a distance • Telehealth
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Telemedicine Defined Diagnosis, consultation, treatment, education and the transfer of medical data using interactive audiovisual and data communications.
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Telemedicine Defined
• Diagnosis, consultation, treatment, education and the transfer of medical data using interactive audiovisual and data communications
• Use of electronic communication and information technologies to provide or support clinical care at a distance
• Telehealth
The Progress of Telemedicine
Dennis O’Brien
ISM 6021
December 9, 2002
Health Care Revolution
• Information technology progress is not as rapid as other industries – financial and human resources deficiencies in
health care
• Most dollars are directed toward medical resources – attracting and keeping IT talent is particularly
difficult for the health care industry
Health Care Revolution
• Most medical establishments spend only 2 to 3 percent of the operations budget on IT functions – traditional attitudes about IT and care giving.
• Most now operate a public web site and intranets – 92% have informational sites on the web– 20% are participating in extranets or supply chain
networks– 15% are offering only enterprise portals
Source: Transformation of the Enterprise Survey; Internet Week, 2000.
Health Care Revolution
• Use of the Web by health care consumers will increase – WebMD and DrKoop.com
• Consumers are more likely to consult their local doctor or hospital than to seek advice online
• Opportunity for regional health care providers – Partners HealthCare System Inc
Health Care Revolution
• Don’t expect to turn a profit on their web based patient services. – to improve service to the provider’s community
• Hospitals and physicians are using web technology to communicate with one another – Amicas Inc– Second-Opinion.com
Establishing A Telemedicine Program• Successful telemedicine programs
– careful planning, – sound management, – dedicated health care professionals, support
staff– commitment to appropriate funding
Establishing A Telemedicine ProgramProgram objectives of telemedicine need to be
well defined(1) Improve access to health care
(2) Enhance a competitive position
(3) Reduce costs
Establishing A Telemedicine ProgramProgram objectives of telemedicine need to bewell defined
(1) Improve access to health care • service availability in remote or difficult to operate
environments • improving access to specialty services • Allows development of local primary care health
centers supported by regional diagnostic centers and hospitals
– State of Alaska north of the Artic Circle
Establishing A Telemedicine ProgramProgram objectives of telemedicine need to bewell defined
(2) Enhance a competitive position• Expand the sponsors market zone to increase
business opportunities • Academic medical centers to support local health
care providers• Increase loyalty of high-volume physicians, e.g.
with ease of access to data from their homes while on-call or in their practice
Establishing A Telemedicine ProgramProgram objectives of telemedicine need to be
well defined(3) Reduce costs
• home care providers
• Prisons
Technology Required
• Integration of medical devices – interface between the caregiver and the patient
• Network computing – permit the storage of data– facilitate the transfer of the desired data
• Video conferencing – transmit sound and data on a real time basis
Source: Family Practice Conference, Annual Session; Philadelphia 2000.
Technology Required
• Software issues – application software
• Device interfaces – assure the flow of information
• Telecommunications options – originating site (live vs. storage) – high bandwidth
Technology Required
• Selecting technology vendors – expertise/experience with telemedicine– provide support– firm that will be around
Can Telemedicine Deliver?
• Many projects underway– emergency telemedicine - video images, audio,
vital signs and ECG rhythm strips transmitted – Yordano - deformed skull with only one eye,
mild MR, and swallowing difficulties; met every other month through videoconferencing
– better digital stethoscopes, and haptic glove not far ahead
Telepathology Transmission
Teleradiology Transmission
Can Telemedicine Deliver?
• Northeast Maine Telemedicine Network – 22 chronic heart and lung disease, terminal
cancer – examine the patients with a camera and
transmitted stethoscope sounds as needed – problems reported by the users were minor
technical glitches
Source: Family Practice Conference, Annual Session; Philadelphia 2000.
Can Telemedicine Deliver?
• Perhaps telemedicine’s most powerful use is international – dramatically speed up the process of spreading medical knowledge.
• Example: Medical Missions has sessions in auditoriums where hundreds of doctors can hear from a US physician
The Cost of Telemedicine
• Cost– Large sponsor
• $134,378 for "spoke" sites to $287,503 for "hub"
• annual transmission costs $18,573 for spokes to $80,068 for hubs
• costs, combined with low utilization in the early years of operation, yielded high unit costs