Telemedicine: 21st Century Medicine
by Jullie Chung, Managing Editor
Telemedicine continues to be a rapidly growing industry within the medical world. Providing global access for medical professionals and medical care to even the remotest locations, telemedicine is a valuable application for practicing clinical medicine.
Telemedicine is generally defined as the exchange of medical information via phone, internet, or other network or electronic means for either consultation or treatment of medical conditions.
The term telemedicine is often confused with “e-health”. E-health is more commonly used as a blanket term that incorporates telemedicine as well as other concepts such as telehealth. The World Health Organization describes e-health as, “the cost-effective and secure use of information and communications technologies (ICT) in support of health and health-related fields including health-care services, health surveillance, health literature, and health education, knowledge, and research” (World Health Organization 2005). Telemedicine itself refers only to the direct dispensing of clinical, medical care.
Telemedicine is most commonly practiced in either real time (synchronous) form, or store-and-forward (asynchronous) form. Real time telemedicine entails the direct interaction between medical professionals or between physician and patient. It could be as basic as a phone consultation, video-conferencing between specialists, or as intricate as the relay of real time medical images and data using networked diagnostic or procedural equipment.
Store-and-forward telemedicine is an indirect means of communication where medical data (i.e. diagnostic images, patient records, monitoring information) is stored and then transmitted at a later date. This form of telemedicine does not require the presence of both parties and is conducted more at the convenience of the sender.
The concept of telemedicine has been in development since the 90’s but has made exponential leaps in capability since then. There have been major advancements in the development and implementation of the end-to-end telemedicine architecture required for information to be transmitted. Network infrastructure has been optimized for speed as well as for security in order to keep all exchange of information HIPAA compliant.
Additionally, medical research and development has allowed for more advanced medical equipment and supplies capable of transmitting data along the telemedicine superhighway. Going beyond the simple video-conference, physicians are now able to utilize tools such as examination cameras, electronic stethoscopes, laptop based ultrasound systems, electrocardiograms, and x-ray scanners to feed information immediately and accurately to a second party in real time. These systems provide opportunities for clinical care in even the remotest of locations.
The application of telemedicine has both national and global scope. In the United States institutions such as the University of Arizona College of Medicine have developed and implemented active and far-reaching telemedicine programs. Senator Robert Burns and Dr. Ronald S. Weinstein partnered in developing what is today the Arizona Telemedicine Program. Funded by the Arizona State Legislature back in 1996, this telemedicine program is state mandated and provides telemedicine services to geographically remote locations within the state of Arizona, to the Native American population, and the Department of Corrections rural prison facilities.
On a global level, organizations like the International Society for Telemedicine and e-Health have already established telemedicine possibilities in diverse countries across the world including Nigeria, China, India, South Africa, Russia, Indonesia, Singapore, Democratic Republic of Congo, Argentina, Venezuela, Brazil, Colombia, Mexico, and Europe. Telemedicine extends the reach of clinical and medical care into areas of the world otherwise inaccessible to modern medicine.
But telemedicine provides benefits and solutions even on a local scale, enhancing the quality of in-home medical care, skilled nursing care, and hospice care. For the elderly, disabled, or those under critical care, telemedicine can eliminate the difficulty of transport to an outside facility for certain care. According to the Telemedicine Information Exchange–funded by the National Library of Medicine–Medicare now covers telemedicine treatment for nursing home patients residing in facilities that support end-to-end telemedicine network capabilities.
In this information age telemedicine is one more bridge to shorten distances and enhance access and efficiency. With more and more facilities, cities, states, locations, and countries becoming telemedicine-ready, we can look forward to a time where medical treatment can be readily provided wherever needed.