Telemedicine in Medicine BT03.03 Definition: “The use of computers, the Internet, and other communication technologies to provide medical care to patients.

Telemedicine in MedicineTelemedicine in MedicineBT03.03BT03.03

Definition: “The use of computers, the Definition: “The use of computers, the Internet, and other communication Internet, and other communication technologies to provide medical care to technologies to provide medical care to patients at a distance.”patients at a distance.”

Forms: Forms: – VoiceVoice– DataData– Still imagesStill images– Motion pictureMotion picture

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TelemedicineTelemedicine

Includes: Includes:

–DiagnosesDiagnoses

–Patient monitoringPatient monitoring

–TreatmentsTreatments

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TelemedicineTelemedicine

Telehealth:Telehealth:

–Larger field that includes health-Larger field that includes health-related educationrelated education

–public health researchpublic health research

–health services administrationhealth services administration

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TelemedicineTelemedicine

Advantages: Advantages:

–Brings high quality medical care to Brings high quality medical care to anyone regardless of distanceanyone regardless of distance

–Decreases patient wait timeDecreases patient wait time

–Decreases patient travel timeDecreases patient travel time

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TelemedicineTelemedicine

Teleradiology: Oldest form of telemedicine Teleradiology: Oldest form of telemedicine using computers and telecommunications . using computers and telecommunications . (send digital x-rays)(send digital x-rays)

Interactive video conferencing: Interactive video conferencing: Conferencing that allows medical Conferencing that allows medical professionals and patients to consult in real-professionals and patients to consult in real-time, using telephones and video screens. time, using telephones and video screens. (patient, Dr. and specialist can all meet at (patient, Dr. and specialist can all meet at the same time from different places)the same time from different places)

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TelemedicineTelemedicine

Telepathology: Transmission of Telepathology: Transmission of microscopic images over microscopic images over telecommunications lines allowing the telecommunications lines allowing the pathologist to view images on a monitor pathologist to view images on a monitor instead of under a microscope.instead of under a microscope.Equipment needed – microscope, camera and monitorEquipment needed – microscope, camera and monitor

Telepsychiatry: Uses teleconferencing Telepsychiatry: Uses teleconferencing to deliver psychotherapy. May not be to deliver psychotherapy. May not be suitable for some types of mental suitable for some types of mental illnessillness. (does not always replace face-to-face counseling). (does not always replace face-to-face counseling) 66

TelemedicineTelemedicine

Remote monitoring devicesRemote monitoring devices– Telespironmetry- Telespironmetry-

used for asthma patientsused for asthma patients information transmitted over telephone lines to remote locationinformation transmitted over telephone lines to remote location

– Arrhythmia monitoringArrhythmia monitoring ECG telemetry that monitors a patient’s cardiac status and ECG telemetry that monitors a patient’s cardiac status and

sends it to a remote locationsends it to a remote location(EMS can send an ECG to the ER (EMS can send an ECG to the ER

from the ambulance to get instructions from the ambulance to get instructions on advance care)on advance care)

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Effectiveness of TelemedicineEffectiveness of Telemedicine

Examining a patient at a distance is not the Examining a patient at a distance is not the same as examining that patient face to facesame as examining that patient face to face

In prisons, telemedicine has led to In prisons, telemedicine has led to decreased costs and improved health care decreased costs and improved health care for inmatesfor inmates

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Effectiveness of TelemedicineEffectiveness of Telemedicine

Medical assistants at the remote sites may Medical assistants at the remote sites may be usefulbe useful

Small hospitals and clinics may find Small hospitals and clinics may find hardware costs prohibitive. It may limit their hardware costs prohibitive. It may limit their resources.resources.

Research studies generally favorable for Research studies generally favorable for medical and medical and cost effectivenesscost effectiveness

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Use of TelemedicineUse of Telemedicine

Health care to the elderly (homebound)Health care to the elderly (homebound) Connect rural primary care physicians to urban Connect rural primary care physicians to urban

specialistsspecialists Allow families of high-risk newborns to watch Allow families of high-risk newborns to watch

babies’ hospital care from homebabies’ hospital care from home Data can be transmitted from ambulance to Data can be transmitted from ambulance to

ERER Patients with chronic illnesses can receive Patients with chronic illnesses can receive

medication reminders at homemedication reminders at home

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Issues in TelemedicineIssues in Telemedicine

Technical issuesTechnical issues–appropriate telecommunications appropriate telecommunications

infrastructure must be in placeinfrastructure must be in placeSome placesSome places lack telecommunication lack telecommunication

lines.lines.

–not available in some rural and urban not available in some rural and urban areasareas

– requires high bandwidth (cable modem)requires high bandwidth (cable modem)1111

Issues in TelemedicineIssues in Telemedicine

Insurance issuesInsurance issues– insurance may not cover all telemedicineinsurance may not cover all telemedicine

Legal issuesLegal issues– licensing laws differ in each statelicensing laws differ in each state– liability is not clearliability is not clear

Privacy issuesPrivacy issues– electronic medical record subject to misuseelectronic medical record subject to misuse– HIPPA (Health Insurance Portability and HIPPA (Health Insurance Portability and

Accountability Act of 1996) Accountability Act of 1996)

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