Download ppt - Telemedicine

April 21, 2023 Dept. of Hospital Administration, AIIMS

Telemedicine

Dr RK PathniAIIMS

(simplified)



What is Telemedicine? “ The delivery of healthcare services, where distance is a critical

factor, by all healthcare professionals using information and

communication technologies for the exchange of valid

information for diagnosis, treatment and prevention of disease

and injuries, research and evaluation, and for the continuing

education of healthcare providers, all in the interests of

advancing the health of individuals and their communities”. WHO(2002)


What is Telemedicine?

Patient and doctor are located in different places

Patients can be examined, treated and monitored

Patient’s data (text, voice, images or even video) can be sent from a remote location and medical advice offered from a speciality Centre.


Calling Names

• Virtual Outreach

• Hospitals Without Walls

• Reaching The Unreached

• Bridging the Urban-Rural divide


“Emergency Medical Care is designed to

overcome the factors most commonly implicated

in preventable mortality, such as delays in

seeking care, access to health facility and

provision of adequate care at the facility.”

WHO (2002)

Need for Telemedicine


“Emergency Medical Care is designed to

overcome the factors most commonly implicated

in preventable mortality, such as delays in

seeking care, access to health facility and

provision of adequate care at the facility.”

WHO (2002)



Golden Hour



Telemedicine ensures delivery of

right medical advice

at the right place

at the right time



• Non availability of facilities locally

• Non availability of appropriate skills / technology locally

• Travel



• Huge population (above 1 billion) with inequitable distribution of resources

• 70% of India’s population lives in rural areas whereas 75% of qualified consultants practice in urban centres

• Vast land area with difficult / inaccessible terrain

• Seasonal isolation of some tracts of land e.g. due to floods, snow, etc

Need for Telemedicine In India


AIIMS : IN-PATIENTS (2004-05)

From outsideFrom Delhi


Advantages of TM

Makes expertise available - anywhere

Early institution of appropriate treatment

need for transfers

Effective utilization of transports

Saves costs to patient , provider, system


On the Basis of Time frame –

• Store & forward

• Real-time

TYPES


Applications

Tm can be utilized in all Clinical applications - medical, surgical, diagnostic

Emergency care Military medicine Disaster management Homecare, Rehabilitation

• TELE-EDUCATION


• Tele-Radiology

• Tele-Cardiology

• Tele-Pathology

• Tele-Ophthalmology

• Tele-Dermatology

• Tele-Psychiatry

• Tele-Surgery

• Tele……..Anything

Types


Features of Telemedicine

Teleconsultation

Telediagnosis

Teletreatment

Telemonitoring

Telepresence


Entities involved in Telemedicine

Telemedicine Platform.

Telemedicine Software.

Clinical Devices.

Communication Media.



Telemedicine Platform Desktop PC Laptop Palmtop / PDA (System in a Suitcase)

+ Clinical Devices Videoconferencing Equipment


Clinical Devices

Contd.

Digital ECG

Electronic Stethoscope

High Resolution Camera

Tele-pathology Microscope

Trinocular Tube

X-Ray Digitizer

FHR, PFT, etc

Digital Camera


Telemedicine Software

Acquisition,

Storage and display, and

Transmission of patient related information


interacts with the system

Application Software Architecture

Backplane

UserInterface

Processing

ProtocolsImage

Acquisition System

PatientRecords

Acquires images and data from the medical equipment

performs specialized imagemanipulation

unites the Service Areas

stores and retrieves patient data

Communications

Secure, transfers data, allocates bandwidth


Telemedicine Software

.

Capturing of images / document from scanner.

Capturing of video / other data from the output of

the medical eqpmt. and conversion to DICOM.

Conversion of DICOM to Non-DICOM format


Media of Connectivity

Terrestrial Connectivity

PSTN / POTS ISDN VSAT LAN / WAN

Mobile Connectivity

GSM (Global System of Mobile Communication) GPRS (General Packet Radio Services) 3G Cell phone with serial / USB Interface to connect PC CDMA


Transmitted Data

Text – History, examination, blood reports etc .

Audio – (MP3 format ) (heart sounds, murmurs, voice, etc )

Still images – (JPEG, TIF, GIF Format)ECG, X-Rays, Ultrasound, CT scan, MRI etc.

Video – (MPEG2 Format)Operative procedures, Echocardiograms, Angiograms , Teleconsultation


Need for speed

Latency or delay factor1 ½ Seconds (VSAT Link )


Objectives of TM

Enable the medical experts to take control of a remote medical

emergency when required

The telemedicine system and sub-system especially at the remote

location should be designed for use by non-medical but trained

personnel

The remote telemedicine system should be designed for easy

portability

The telemedicine solution should be cost effective requiring

minimal training, installation and maintenance

The telemedicine equipment used should use a optimum

bandwidth for data communication


A Model for TM

TeleMedicine Specialty Center

TM Consulting Centre

Remote Site



Mobile TMU


Mobile TM Unit

Contd.

• Diagnostic Devices

• Communication Media

April 21, 2023 Dept. of Hospital Administration, AIIMS Contd.

System Required at Base Unit

The base unit consist of –

Computer with telecommunication facility.

Multimedia Software for displaying biosignals and view Digital images.



Tele Consulting Center


Usage Scenario

The patient is examined and the data is embedded in an encrypted message and sent to the referring site's server

The specialist opinion

Diagnosis is sent back and if required video conferencing is used


Problems

Reliability of connectivity

Need for speed- (Bandwidth)

Legal issues, Licensing

Data Security, Patient confidentiality

Learning Curve

Resistance to change

Standards


Reality ?

Technical demonstrations of the future - Tele-presence surgery / Tele - Robotic Surgery

1992 experimental demonstrations

1997 – Lapcholecystectomy

1998 - Beating heart surgeries

Tele Hypnosis


CONCLUSION

TM is for real and real-time TM

interventions are practical

Potential to reduce costs and

save lives


Telemedicine is a concept, a

tool. Its use is limited only by

your

imagination.
