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TelehealthTelehealth In the New Millennium In the New Millennium
Michele L. Hales
University of Alberta
Edmonton, AB CANADA
ISN: Informatics SymposiumISN: Informatics Symposium
February 5, 2001February 5, 2001 Dubai, UAEDubai, UAE
Presented Presented atat
What is Telehealth?What is Telehealth?
"Telehealth is defined as the use of communications and information technology to deliver health and health care services and information over large and small distances."
Director General of W.H.O.Director General of W.H.O.
Dr. Hiroshi Nakajima, the Director-General of the World Health Organization (WHO) pointed out that information and telecommunication technology, as “one of the main driving forces in the current globalization of trade, economics and politics”, and it had “equally important implications for health.”
TELECOM 97 Forum
TransmissionTransmission
Telephone lines are slow but inexpensive at 64 kilobytes per second (baud)
ISDN telephone lines – integrated service digital network is faster at 256 kb
ATM – asynchronous transfer mode >1Mb
Satellite – expensive
Categories of Information FlowCategories of Information Flow
Data• interactive, data entry,
batch, file update, file transfer, file sharing
Image• fax, graphics, conferencing,
interactive, store/forward
Voice• voice only, voice/data,
inquiry/retrieval, conferencing, store/forward, recording
Video• conferencing, screen
capture, interactive, recording
Information Monitoring: network management, security, integrity, licensing, malpractice
Valuable Product & ServicesValuable Product & Services
Source: VHA Annual Information Systems Survey 1998
Richard D. Lee, Dierdre A Conley, Andy
Preikschat: WitCapital.
eHealth 2000: Healthcare and the Internet
in the New Millennium. January 31, 2000
Available at:www.witcapital.com/research/researchbody.jsp?Report=ehlt_20000131
A transitionA transition::
TelehealthTelemedicine e-health
e-health is now the term to use when describing the rise of digital technologies, electronic transmission and the convergence of technologies.
Mitchell, John:From Telehealth to E-Health: The Unstoppable Rise of E-Health. 1999. Department of Communications, Information Technology and the Arts, Australia.
TelehealthTelehealth
Clinical diagnosis Direct care delivery Tele-education/telelearning (including patients
& professionals) Telemedicine Telematics (for health research and health
services management)
Integration of information technology in healthcare has tremendous potential, which is only now being realized.
Telehealth/E-healthTelehealth/E-health
Telehealth is moving closer to e-commerce Health information is being disseminated via
the web A more well-informed consumer Increased patient knowledge increases
challenges to the healthcare providers decisions
The primary care physician of the future is the patient (or guardian)
Telemedicine, telehealth,Telemedicine, telehealth, e-healthe-health
Consumer-driven
Provider-driven
e-health
Telemedicine and Telehealth
The public will tell us what they wantThe public will tell us what they want in e-health. in e-health. Providers no longer dictateProviders no longer dictate but become but become
partners with patient or partners with patient or clientclient..
Driving Forces of TelehealthDriving Forces of Telehealth
Health and socioeconomic needs Shortage of specialists in remote regions Sense of professional isolation Demand for equitable and accessible
healthcare services Decrease in cost for equipment &
telecommunication Aging population
Trends in TelehealthTrends in Telehealth
Increased use in correctional facilities and home health care settings.
Fine-tunes the management and allocation of rural health care emergency services by transmitting images to key medical centres for long distance evaluation/triage by appropriate medical specialists.
Permits physicians doing clinical research to be linked together despite geographical separation, sharing patient records an diagnostic images.
Improves medical education for rural health care professionals.
Strengths & BenefitsStrengths & Benefits
Empowers the public Strengthens and integrates healthcare services Creates information resources, continuing
education & training to healthcare providers Increases accessibility of specialty care to
underserved populations Telehealth applications provide foresight to new
possibilities Provides support to providers Provides instant communication with colleagues
Some Telehealth ChallengesSome Telehealth Challenges
Policy issues: Liability, licensure and reimbursement
Need for technical and professional standards Privacy, confidentiality and security must be
addressed Need to stay abreast of changes in funding for
projects Acceptance of the technology Infrastructure barriers to some rural areas –
possibly the greatest challenge
OpportunitiesOpportunities
Collaboration:
- various government agencies
- health organizations
- industry Strengthen incentive program Develop and exchange knowledge
Successful Telehealth EndeavoursSuccessful Telehealth Endeavours
School-based health centers Hibernia off-shore oil drilling platform Correctional Facilities Tele-
- dermatology- radiology- cardiology- oncology- surgery- psychiatry- pediatrics
Teledialysis (OSMH)Teledialysis (OSMH)
Orillia Solider's Memorial Hospital (OSMH) - established Canada's first region-wide, teledialysis network.
Using computerized systems, the OSMH monitors patients at least 100 kilometres from the regional centre, bringing healthcare services closer to home.
The network officially opened in October 1997.
Teledialysis (OSMH) cont’d:Teledialysis (OSMH) cont’d:
Linked via ISDN lines, a high-speed phone connection allowing videoconferencing to take place between doctor and patient in real-time.
To achieve a complete transfer of data, three ISDN lines are going at the same time.
Excellent picture quality
Teledialysis (OSMH) cont’d:Teledialysis (OSMH) cont’d:
Dialysis machines are connected via modem, through a standard phone line to the server at the regional centre. From there, the information is transmitted to the screen.
Enables patients to videoconference with remote doctors.
It provides medical follow-up care for stable hemodialysis patients.
Provides patient privacy
Telehealth Initiatives Globally:Telehealth Initiatives Globally:
Armenia Australia Canada Europe South Africa United States of America
E-mail Discussion ListsE-mail Discussion Lists
TELEHEALTHTo: [email protected]: Subscribe TELEHEALTH YourName
E-HEALTHTo: [email protected]: Subscribe EHEALTH YourName
NETPSYTo: [email protected]: Subscribe NETSPY YourName
ITNATo: [email protected]: Subscribe itna FirstName LastName
PublicationsPublications
Journal of the American Medical Association - jama.ama-assn.org/
MD Computing - www.mdcomputing.com/ Telehealth Magazine - www.telehealthmag.com/ Telehealth Net - telehealth.net/ Telemedicine Journal - www.liebertpub.com/TMJ/ Telemedicine Today - www.telemedtoday.com/ Telemedlaw
Organizations & Associations:Organizations & Associations:
Association of Telehealth Service Providers
- www.atsp.org Canadian Society of Telehealth
- www.ucalgary.ca/md/CST/ California Telehealth and Telemedicine Center
- telemed.calhealth.org/ Finnish Society of Telemedicine
- www.fimnet.fi/telemedicine/engindex.htm
Organizations & Associations cont’d:Organizations & Associations cont’d:
Healthcare Information and Management Systems Society (HIMSS)
- www.himss.org International Society for Telemedicine (ISFT)
- isft.org National Centre of Telemedicine, Tromso,
Norway - www.telemed.rito.no/Eng/index.html
Office for the Advancement of Telehealth - telehealth.hrsa.gov
Telehealth FutureTelehealth Future
Precedents are now being set New generation of technology arrives
every 18 - 30 months The future is being shaped by us now
ConclusionConclusion
Telehealth is just another way to practice what one already knows how to do, but through a new means
It will be the way of the future
““The computer is very fast, accurate The computer is very fast, accurate and stupid. Man is very slow, and stupid. Man is very slow, inaccurate and brilliant. Together they inaccurate and brilliant. Together they make an unbeatable team.make an unbeatable team.””
---- Albert Albert EinsteinEinstein
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