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TELEMEDICINE

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TELEHEALTH & TELEMEDICINE

What is the difference between Telehealth and Telemedicine?

Telehealth can either refer to clinical and/or non-clinical services.
Telemedicine only refers to the provision of clinical services

Introduction

The advancement in telecommunication and satellite communication in the recent years has experienced many fold development in India in IT enabled services, BPOs, Overseas communication, rural telephony, and also in the field of medicine.
Telemedicine is the new buzz word amongst the healthcare administrators around the world.
In the last decade leading hospitals and healthcare providers in India have used telemedicine as a medium of communication between medical fraternity in seeking opinion for rendering better patient care services and sharing of knowledge base to the fellow counterparts.
Making healthcare accessible reduces investment in health thus contributing to overall economic and social development. India faces various problems in the provision of medical services and health care, including
funds,
expertise and
resources.
Telemedicine has the potential to improve both the quality and the access to health care regardless of the geography. It enables medical and health care expertise to be accessed from under served locations.

TELEMEDICINE?


Tele-medicine system consists of customized medical software integrated with computer hardware, along with diagnostic instruments connected to the VSAT (Very Small Aperture Terminal) at each location.
Generally, the medical record/history of the patient is sent to the Specialist Doctors, who will in-turn study and provide diagnosis and treatment during video-conference with the patient's end.

What is telemedicine

It consists of three elements:

Firstly, it uses the information technology to provide information for medical decision making.
Secondly, it changes signals which could be Bioengineering components.
Thirdly, arrange the practice for medicine at distance

Objectives of Telemedicine

To enhance citizens' equality in the availability of specialised medical services by bringing these services to remote primary health care centers.

To promote the proficiency of physicians and other health care personnel by means of teleconsultation and video conference based training

To reduce the waiting lists in specialised health care, e.g. for glaucoma and retinopathy screening and follow-up, and for initial and follow-up visits in surgery.

NEED FOR TELEMEDICINE

In India only one-third of households are in urban areas, with remaining two-thirds in rural areas but majority of healthcare activities and availability of healthcare facilities are present in urban areas
Non availability of adequate number of resources and the challenge to overcome can possibly be done by (
a) Making specialist services available in rural / remote healthcare settings and
(b) Making critical care accessible to rural / remote areas.

NEED FOR TELEMEDICINE

Tele-medicine helps patients in rural and distant areas to avail timely consultations of Specialist Doctors without going through the ordeal of travelling long distances.
The facility enables transmission of patient's medical records including images, besides providing live two-way audio and video link.
With the help of these, a Specialist Doctor can advise a Doctor or a paramedic at the patient's end on the course of treatment to be followed. He can even guide the Doctor during a surgery.
In the context of rural and distant areas, the Tele-medicine-based medical care is also highly cost effective.

Examples

Some examples of telemedicine

teleconsultation,
telemonitoring,
telediagnosis,
teletreatment,
telecare-provision.
Store and forward

Video conferencing

Any videoconferencing terminal must have a
few basic components:
a camera (to capture local video),
a video display (to display remote video),
a microphone (to capture local audio),
and speakers (to play remote audio).
optionally a docum

Telediagnosis

To perform diagnosis remotely
Patient-to-doctor connection (vs.
doctor to doctor connection in
Teleconsultation
Mobile tele-medical unit can perform specialist care (central hospital standard) studies in health care centres usingmobile telemedical units.
The results can be sent to super specialty hospital, thus
permitting telediagnosis

TELEMEDICINE IN INDIA

One of the recent applications of space technology initiated by ISRO is in the field of Tele-medicine to provide expert medical services to the rural and remote areas.
Under the Tele-medicine project, Hospitals/health centers in remote locations are linked via INSAT satellites with super specialty Hospitals at major towns/cities, bringing in connectivity between patients at remote end with the Specialist Doctors for medical consultations and treatment.
Tele-medicine pilot projects are undertaken by ISRO with the involvement of selected super specialty Hospitals located in major cities and smaller health centers in distant and rural areas.

TELEMEDICINE IN INDIA

Indian Space Research Organisation has done pioneering work by partnering with leading healthcare providers, various state governments in making healthcare accessible in the rural and remote parts of the country.
With the advent of communication technology especially the Satellite Communication (Sat-Com) combined with Information Technology, enables benefiting from the advanced medical sciences to reach even the remote and inaccessible areas.
Indian Space Research Organisation (ISRO) as a part of application of space technology for Health care and education, under GRAMSAT (rural satellite) programme, has initiated number of Telemedicine pilot projects which are very specific to the needs of development of the society.

TELEMEDICINE IN INDIA

With the inception of the program, it has been implemented in the remote areas of north eastern states of Tripura, Nagaland and in south Indian state of Karnataka in its tribal belt.
Integrated Telemedicine Tele-health Project is the first-of-its-kind initiative jointly sponsored by Indian Space Research Organisation (ISRO), Asia Heart Foundation in Kolkata and Narayana Hrudayalaya in Bangalore was initiated in 2001.

TELEMEDICINE IN INDIA

ISRO’s satellite based Telemedicine network, which started in 2001 on an experimental basis has linked remote/rural district hospitals with super-speciality hospitals in major cities via INSAT. While ISRO provides the software, hardware and communication equipment as well as satellite bandwidth, the speciality hospitals provide the infrastructure, manpower and maintain the system. ISRO’s telemedicine network has matured into an operational system and now covers 165 hospitals – 132 remote/rural/district hospitals/health centres connected to 33 speciality hospitals located in major cities.

TELEMEDICINE IN INDIA

ISRO’s satellite based Telemedicine network, which started in 2001 on an experimental basis has linked remote/rural district hospitals with super-speciality hospitals in major cities via INSAT.
While ISRO provides the software, hardware and communication equipment as well as satellite bandwidth, the speciality hospitals provide the infrastructure, manpower and maintain the system.
ISRO’s telemedicine network has matured into an operational system and now covers 165 hospitals – 132 remote/rural/district hospitals/health centres connected to 33 speciality hospitals located in major cities.

TELEMEDICINE INSTRUMENTS

Telemedicine enables access to specialists for seeking their opinion in shorter time with accuracy, efficiency and precision.

Provide expert advice to remote locations
Link medical professionals by utilizing live video from    a microscope through video conferencing software
Offer instant answers to patients or other clinicians through live video communication
Display real-time motion video over broadband    networks through existing PC or room-based video
Create easy to use, affordable and scalable solution

Mobile Video Cart with
Digital Stethescope


The i8570 MVC is specifically designed for applications where a compact, mobile system is required. The i8750 MVC can be utilized for many clinical applications, such as remote consultations, rural health care and emergency response, as well as administrative meetings and continuing medical education.

StethOne™ Chest Piece Set

The StethOne™ Telephonic Stethoscope transmits and receives heart sounds through high speed broadband connections or through most videoconferencing systems for the ultimate in medical video conferencing. This patient transmit package includes; one - dual noise reduction headset, one - extended frequency transmit and receive bases and one - chest piece.

Telemedicine carts are essential in today's hospital environment.
Full solution medical carts with portable video conferencing systems enable doctors, nurses, patients, practitioners and other individuals involved in medicine to communicate directly.
Portable Medical carts with wheel base and flat screen monitors make it easy to transport the medical video conferencing cart.

LIMITATIONS OF TELEMEDICINE

Expensive Telemedicine Software and high tech gadgets like digital cameras, online microscopes, medical scanners used in transfer and storage of medical data like X-Rays, CT Scans & MRIs get eliminated in centres where there is no facility for a patient to access and undergo such high-tech examinations in the first place
Trained manpower

Conclusion

Telemedicine offers solutions for emergency medical assistance, long-distance consultation, administration and logistics, supervision and quality assurance and education and training for health care professionals and providers.
Telemedicine needs to be implemented carefully and managed well. The impact of telemedicine on health care structures can be significant. In this respect, telemedicine can be seen as a tool that is being used to build up new health care horizon. However, there are

Telemedicine needs to be implemented carefully and managed well.
The impact of telemedicine on health care structures can be significant. In this respect, telemedicine can be seen as a tool that is being used to build up new health care horizon.
However, there are also concerns about liability, confidentiality and other policy, regulatory issues and pricing.


Conclusion


The medical establishment is not currently equipped to address this problem
A partnership between medicine, engineering, law, business, economics, social sciences, and other disciplines is required
No entity currently owns the problem
Not primary, secondary healthcare bodies nor any private concerns
This work could be “birthed” at the local level and then “raised” at the national
Workshops / pilot initiatives would help provide insights needed to engender a national dialog
If successfully cultivated, healthcare delivery science will necessarily drive industry

Conclusion

Need to adopt sound policies and strategic plans which can guarantee the provision of high quality, sustained and integrated health care services to the population.
Such provisions are required to be developed in order to make healthcare more accessible to the rural and remote areas with few entrepreneurs to lead.