What is Telemedicine
Telemedicine is the practice of providing interactive health care by utilizing modern technology and telecommunications equipment. With telemedicine, medical information is transferred through audiovisual media in order to consult with a health care professional in another location or carry out a remote medical procedure or examination.
Telemedicine runs the gamut from a simple case of two health professionals discussing a patient on the telephone to a complex situation of using videoconferencing equipment and satellite technology to consult with medical specialists around the world.
Modern telemedicine has evolved from a long-practiced tradition of in absentia care, or remote care. African villagers used smoke signals to warn people to stay away from the village in cases of disease. In Australia in the early 1900s, people living in remote areas used two-way radios to solicit medical advice from the Royal Flying Doctor Service of Australia.
Today’s telemedicine is made up of three main areas: store and forward, remote monitoring and interactive services. Store and forward telemedicine involves taking medical data or images and sending them to be assessed by a medical professional at a later time. This process requires the physician to rely on the patient’s history report and audio/video information instead of a proper physical examination. This is typically used for non-emergencies, when a diagnosis can wait 24 to 48 hours until the responses can be sent back. This form of telemedicine is widely used in the fields of dermatology and radiology.
Remote monitoring, also known as self-monitoring, allows doctors to monitor a patient remotely using technological devices. This method is generally used for managing patients with heart disease, diabetes or asthma. Remote monitoring saves both the patient and the health care industry time and money by avoiding hospitalizations for the purpose of patient observation.
Interactive telemedicine, sometimes called real-time telemedicine, allows immediate interaction between patient and physician, including phone conversations, online communication and remote “home” visits. Interactive telemedicine can also be used for physician supervision of a clinician who is not a doctor.
The field of radiology is heavily steeped in telemedicine. Radiographic images such as X-rays, scans and ultrasounds can be sent from one computer to another via the Internet, without requiring any additional special equipment, allowing thousands of images to be “read” by remote providers each year. Cardiology is another specialty regularly using telemedicine. An electrocardiograph (ECG or EKG) can easily be transmitted across a telecommunications network, patients with heart conditions can have their vital signs monitored remotely by a hospital and pacemaker readings can be recorded and sent to the appropriate medical specialists for evaluation. Other major specialty areas using telemedicine include dermatology, mental health, ophthalmology and pathology. According to some reports, almost 50 different medical subspecialties have successfully used telemedicine.
Additional benefits include family support when telemedicine allows patients to remain in their communities rather than be in a health care facility, financial savings by not having to transfer extensively to receive health care, easier access to specialists and higher degree of confidentiality since physical presence is not required.
Telemedicine is also becoming critical in non-typical health care settings. Correctional facilities have begun using telemedicine as a way around the cost and risk of transporting inmates to health facilities. Some schools have implemented telemedicine programs to expand school health services by enabling school nurses to consult with physicians. The military has gone one step further in developing robotics equipment that can be operated by a surgeon in one location on a patient in another location, such as on a battlefield.
There are still a number of barriers to telemedicine. These include the licensing of out-of-state physicians providing health care services in another state, insurance reimbursement issues for telemedicine “visits,” fear of malpractice suits, lack of appropriate telecommunications technology in many health care settings, as well as a decline in federal funding for telemedicine programs.