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What is Telemedicine?

Here is the definition I have used over the past ten years or so to describe Telemedicine:

"Telemedicine is the ability to provide interactive healthcare utilizing modern technology and telecommunications." Basically, Telemedicine allows patients to visit with physicians live over video for immediate care or capture video/still images and patient data are stored and sent to physicians for diagnosis and follow-up treatment at a later time. Whether you live in the center of Los Angeles or deep in the Brazilian Amazon, Telemedicine is an invaluable tool in Healthcare.

Here's an example of how Telemedicine works everyday. Say you have a horrible sore throat and visit your healthcare provider (could be a general practice physician, nurse practitioner, or unlicensed health worker in a village depending where you live), who does an examination and is concerned with what he sees. Your provider recommends a referral to an ENT specialist for a follow up diagnosis and treatment plan. Well, instead of traveling to the nearest specialist, which depending where you live could be anywhere from a 45-minute drive or an 18-hour boat ride up the Amazon River, your provider connects you directly to the ENT specialist via Telemedicine.

Here are some of the major benefits of a Telemedicine Consultation:

•	The specialist actually hears your medical history and current condition directly from you and your provider instead of the specialist receiving a dictated note in the mail.
•	With the use of ENT medical peripherals such as a nasopharyngoscope, your provider can pass this medical peripheral into your nasal passage which will allow your provider and the ENT specialist simultaneous crystal clear video of your throat and vocal cords. The specialist may ask you to cough, pronounce letters, etc. in order to get the best outcome for the diagnosis.
•	The specialist can diagnose and recommend treatment immediately.
•	Your provider has the opportunity throughout the examination to ask questions and learn from each and every consultation. The continual education of your provider via medical consultations is an immeasurable benefit to all his patients.

Telemedicine Usage Models

Real-Time

This is the most common use in Telemedicine. Like the example above, live video allows the provider, patient and specialist to all communicate together to achieve the best outcome for the patient.

	In or outpatient specialty consultation Physician supervision of non-MD clinician Generally require higher bandwidths (minimum 256kb)

Store and Forward (asynchronous)

Used when both health providers are not available or not required at the same time. The provider's voice or text dictation on the patient's history, current affliction including pictures and/or video, radiology images, etc., are attached for diagnosis. This record is either emailed or placed on a server for the specialist's access. The specialist then follows up with his diagnosis and treatment plan.

Home Health Telemedicine

When a patient is in the hospital and he is placed under general observation after a surgery or other medical procedure, the hospital is usually losing a valuable bed and the patient would rather not be there as well. Home health allows the remote observation and care of a patient. Home health equipment consists of vital signs capture, video conferencing capabilities, and patient stats can be reviewed and alarms can be set from the hospital nurse's station, depending on the specific home health device.

• Usually low bandwidth analog Plain Old Telephone System (POTS). Some newer systems do support higher bandwidth capabilities.
• Disease management, post-hospital care, assisted living, etc.
  
  

Summary of Benefits of Telemedicine

To Rural Physicians and clinics (spoke sites)

• 	Receive education from the specialist/provider Better health outcome for their patients Enhanced community confidence in local healthcare Attend continuing medical education courses from their clinic

  
  
• To Patients
  
  

Loved ones remain in their community with family support Cost savings from not having to travel extensively Immediate urgent care Confidentiality of specialty examination or visit (Because the patient visits the general practice doctor, he can be seen for any specialty care without anyone else knowing) Patient education courses (nutrition, oncology, etc.) Properly stabilize patient prior to transport Early Diagnosis prior to escalated medical episode

Rural Patient's Community

	Dollars follow the patient Patients that routinely travel to visit doctors in large urban areas tend to purchase their goods and services from those cities, Telemedicine keeps those dollars local.

To Telemedicine Providers (hub sites)

	Expand patient outreach Major surgical procedures resulting from the initial telemedicine consultation Reduction in ER visits Promotion of Hospital Charge tuition for clinician education courses (CME, CNE, etc.)

 

• How can we give any hospital or clinic immediate access to a vast amount of medical experts, healthcare education/information, and support from other physicians.

How can we take all these resources and share them immediately and effectively with any hospital or clinic in the world?

We can use Telemedicine!