Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities. It is also used to save lives in critical care and emergency situations. Ronald Leach and colleagues at Howard University describe a highly asynchronous service model for healthcare delivery. The approach is much cheaper to implement than direct medicine and even less expensive than other approaches to telemedicine that have been suggested for rural and developing parts of the world. The approach to rolling out their solution is entirely incremental and would provide improved health service even in the initial stages before the system is fully implemented, the team says. "Our proposed service model provides relatively comprehensive, but not universal, healthcare coverage," says Leach.
Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities. It is also used to save lives in critical care and emergency situations. Ronald Leach and colleagues at Howard University describe a highly asynchronous service model for healthcare delivery. The approach is much cheaper to implement than direct medicine and even less expensive than other approaches to telemedicine that have been suggested for rural and developing parts of the world. The approach to rolling out their solution is entirely incremental and would provide improved health service even in the initial stages before the system is fully implemented, the team says. "Our proposed service model provides relatively comprehensive, but not universal, healthcare coverage," says Leach.
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Although there are distant precursors to telemedicine, it is essentially a product of 20th and 21st century telecommunication and information technologies. These technologies permit communications between patient and medical staff with both convenience and fidelity, as well as the transmission of medical, imaging and heath informatics data from one site to another.
Early forms of telemedicine that have been achieved with telephone and radio have been supplemented with videotelephony, advanced diagnostic methods supported by distributed client/server applications, and additionally with telemedical devices to support in-home care.
The promise is that telemedicine could bring medical expertise to remote areas without the expense and difficulties of trying to bring the experts to the patients or requiring many of those patients from such regions to go to central hospitals or clinics. There is also hope that telemedicine might allow epidemics to be more quickly contained as information is shared and emerging problems addressed more rapidly.
This form of telemedicine is, however, expensive in itself and not amenable to the poor infrastructure of many rural developing communities.
Fundamentally, rural developing communities mostly do not have the information technology bandwidth to support synchronous (same time or instantaneous) telemedicine. However, there is often adequate technology for some communication and Leach and colleagues suggest that this might be exploited in asynchronous (not occurring at the same time) telemedicine.
The following shows how asynchronous telemedicine might benefit a patient who is seen by a local healthcare worker or can reach a rural clinic. This is primarily by using less utilized satellite network systems and a database. The approach also exploits the daylight time difference between Africa and the US to utilize bandwidth on communications satellites at a time when US users are least active.
1 The healthcare practitioner makes a preliminary analysis of the patient's condition and enters information into a laptop or cell phone.
2 The healthcare practitioner connects a cell phone or laptop over satellite networks to the electronic healthcare records, database stored somewhere in the cloud of servers in the USA.
3 The healthcare practitioner queries the database for information on this patient or on local outbreaks of relevant diseases.
4 A minimal, text-based set of information is sent to the healthcare practitioner's laptop or cell phone over the underused satellite network.
5 Based on the information received, the healthcare practitioner treats the patient.
6 If the medical situation can wait, the local healthcare provider asks for additional medical opinions from colleagues in his or her own county or in the USA.
7 After the patient is treated, the results of the treatment are uploaded by the healthcare practitioner to the patient's record stored in the cloud.
8 The process described in steps 1 to 7 are repeated if necessary.
For further information: http://medicalxpress.com/news/2011-12-limited-telemedicine-health.html
Photo: http://www.stjosephshealth.org/index.php/telemedicine
