Telemedicine is an emerging field of convergence of medicine, technology and communication. It promises the best of medicinal facilities to people in rural or far flung areas. Telemedicine provides local medical staff the guidance of an expert physician far from the site of emergency. Such timely diagnosis and treatment increases the chances of patient survival. Information and communication technologies (ICTs) are expanding the availability and affordability of healthcare services. These technologies integrate electronic electronic medical information, clinical assessment tools and laboratory data to bring state of the art medical expertise to undeserved areas. Seamless sharing of information between healthcare providers has enabled the concept of hospitals without walls.
Patient data,both clinical and non-clinical, is crucial for accurate diagnosis and appropriate treatment. Clinical information includes history of illness, associated signs and symptoms, clinical observations and interventions, diagnosis and treatment, etc non-clinical information includes information about the patients’s environment , demographic information, lifestyle and occupation and any other relevant information for providing daycare. In most of the situations, early diagnosis and initiation of treatment can save patients’s life. For hard-pressed local medical staff with a serious or unusual medical condition, the ability to consult specialists elsewhere can mean the difference between life and death of the patient. With advances in telecommunication in formation processing capability and miniaturization of health diagnostic equipment, it has become possible to deliver immediate and effective healthcare to the masses.
Voice, video and data are electronically communicated for consultation between geographically separated clinicians. This involves:
a) Telemonitoring: Use of Audio-visuals, electronic signal/information processing and telecommunication technologies to monitor the patient’s such details as measurements taken from devices such as blood pressure cuff, blood oxygen, thermometer, stethoscope, weigh scale, blood glucose, meter, etc.
b) Telediagnosis: Detection of a disease by observation and evaluation of the patient data acquired and transmitted from the equipment/devices monitoring the remote patient.
c) Telementoring: Using telemonitoring an expert consultant guides a distant clinician in a new medical procedure.
Data acquisition and transfer
Data can be transferred in two ways: store-and-forward and real-time interactive video. The choice depends on the clinical setting, purpose of the consultation, infrastructure and economic considerations. Emerging rends in remote monitoring and diagnosis Electronic patient record. An Electronic patient record (EPR) are the electronically stored health information about any individual uniquely identified by an identifier which entails capturing, storing, retrieving, transmitting and manipulating patient specific healthcare data (including clinical, administrative and biographical data).
Home Telecare: The home telecare solution allows visual assessment of the patient, tracking of vital signs and review of the medications remotely,eliminating the need for the physician to be the physically present or the patients who may otherwise be unable to receive them due to geographic distance barriers. thus it holds a great promise in managing the health needs of individuals living in rural and remote areas. The home telecare system comprises a home care unit serving as the video interface, a camera and a gateway.
Emergency care: These devices have the ability to telematically “bring in” an expert emergency, allowing him to review the vital signs and issue directions on patient managements and treatment procedures to the emergency personnel until the patient is administered first aid and the hospital. This results in effective patient management, as the patient and initiate the treatment immediately. Medical Images and waveform can even be downloaded, stored, displayed and exchanged on personnel digital assistants (PDAs) and mobile phones, so these can be accessed at any time, anywhere to aid remote diagnosis and referrals.
Smart cards: Smart cards act as a portable, comprehensive and accurate source of up-to-date patient information. These can provide basic medical information about the patients, such as lists of drug sensitivities, current conditions being treated, name and phone number of the patients’s doctor and other information vital in an emergency. These can also carry vital medical history and details about insurance coverage. Remote diagnostics and related decision-making process can be integrated efficiently as the patients could carry the repository of information wherever he/she goes to receive treatment.
Telesurgery: Telesurgery is the provision of surgical care over a distance, with direct, real-time visualization of the operative field. it may be categorized into telepresence surgery and telerobotics. telepresence surgery uses a computerized interface to transmit a surgeon’s actions at the surgical workstations to the operative site at the remote surgical unit, with haptic feedback about the tactic environment of the operative fields to the surgeon. Telerobotics is remote control with a robotic arm, usually in conjunction with a laparoscope, without haptic feedback. In the future, though telemedicine will take some time to be available to ordinary people, it will have the greatest impact in the area of home healthcare, since the efficiencies realized are unimaginable.