11d e Medicine

8/9/2019 11d e Medicine

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E-Medicine

"e-medicine is the ability to provide interactive healthcare utilizing modern technologyand telecommunications." Basically, e-medicine allows patients to visit with physicians liveover video for immediate care or capture video/still images and patient data are stored andsent to physicians for diagnosis and follow-up treatment at a later time. Whether you live inthe center of Los ngeles or deep in the Brazilian mazon, e-medicine is an invaluable tool in!ealthcare.

Here's an example of how e-medicine 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. !our provider recommends a referral to an "#$ specialist for a

follow up diagnosis and treatment plan. %ell, instead of traveling to the nearest specialist,

which depending where you live could be anywhere from a &-minute drive or an )-hour boat

ride up the *ma+on iver, your provider connects you directly to the "#$ specialist via e-

medicine.

!ere are some of the maor benefits of a e-medicine #onsultation$

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 providercan 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 bestoutcome for the diagnosis.

The specialist can diagnose and recommend treatment immediately.

Your provider has the opportunity throughout the examination to ask uestions and learn

from each and every consultation. The continual education of your provider via medical

consultations is an immeasurable benefit to all his patients.

e-medicine Usage Models

eal-$ime

%his is the most common use in e-medicine. Li&e the e'ample above, live video allows the provider, patient

and specialist to all communicate together to achieve the best outcome for the patient.

!n or outpatient specialty consultation

"hysician supervision of non#$% clinician &enerally reuire higher bandwidths 'minimum ()*kb+

Store and orward (asynchronous

(sed when both health providers are not available or not re)uired at the same time. %he provider*s voice or

te't dictation on the patient*s history, current affliction including pictures and/or video, radiology images,

etc., are attached for diagnosis. %his record is either emailed or placed on a server for the specialist*s

access. %he specialist then follows up with his diagnosis and treatment plan.


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Home Health e-medicine

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. !ome health allows the remote observation and care of a patient. !ome health e)uipment 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.

(sually low bandwidth analog +lain ld telephone ystem +%. ome newer systems do supporthigher bandwidth capabilities.

0isease management, post-hospital care, assisted living, etc.

Summary of Benefits of e-medicine

$o ural /hysicians and clinics (spoke sites

eceive education from the specialist-provider

etter health outcome for their patients

Enhanced community confidence in local healthcare

/ttend continuing medical education courses from their clinic

$o /atients 0oved ones remain in their community with family support

1ost savings from not having to travel extensively

!mmediate urgent care

1onfidentiality of specialty examination or visit 'ecause the patient visits the

general practice doctor, he can be seen for any specialty care without anyone else

knowing+

"atient education courses 'nutrition, oncology, etc.+

"roperly stabili2e patient prior to transport

Early %iagnosis prior to escalated medical episode

ural /atient's 0ommunity - upees follow the patient "atients that routinely travel

to visit doctors in large urban areas tend to purchase their goods and services from those

cities, e#medicine keeps those upees local.

$o e-medicine /roviders (hub sites

1'pand patient outreach

2aor surgical procedures resulting from the initial e-medicine consultation

3eduction in 13 visits

+romotion of !ospital

#harge tuition for clinician education courses #21, #41, etc.


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1-2edicine is not an evolutionary concept but a revolutionary concept in itself. 5t represents avery innovative approach in providing )uality health care whenever and wherever needed, but is seenlac&ing reliability, user friendliness 6 most importantly governmental support.

5n fact the main challenge facing website administrators, software engineers, systemdevelopers 6 medical practitioners is to develop strategies that will give e- care a reliable environmentto e'ploit opportunities and ma&e it more feasible 6 cost effective.

%he current synergy between health reform initiatives which are defining how health care

services are accessed and delivered and advantages in technologies that support e-medicineproects has resulted in proliferation of e-medicine proects. %he e'isting scenario demands that thedevelopment of e-medicine strategy be based on a sound &nowledge of the present and futurepotential of e-medicine to improve health care access and )uality, while reducing health care costs.

%hat is "-1edicine 2

5t has been defined 7as the use of telecommunication8 to provide medical information andservices. 5t may be as simple as two health professionals discussing a case over the telephone, or assophisticated as using satellite technology to broadcast a consultation between providers at twodistant locations, using videoconferencing e)uipment.

%he simplest definition of 1-2edicine is that it uses multimedia technology voice, video and

data to deliver medical services. %he lower cost of bandwidth and improvement in video and data

compression standards have increased the number and types of medical services that can bedelivered from a distance to include virtually every specialty.

1-2edicine is an application and not a technology. 5t uses a hybrid technology incorporatingelements of television, telecommunication, computers, engineering and medicine. ervices can bedelivered on a combination of technologies with a variety of e)uipment.

3b4ectives of "-medicine

71-2edicine is not an evolutionary concept but a revolutionary concept and at the heart ofevery revolution, there is the need for a sudden massive change, at the core of which is the humanmind.8 By ta&ing into consideration 7!ealth 9or ll,8 we:ll discuss some obectives for which 1-2edicine has originated.

;. %o ma&e high )uality healthcare available to traditionally under privileged population - 5n 5ndia,

there is a large rural based population separated by large distances which need access toregular )uality medical care. 1-medicine can enhance citizen:s e)uality in the availability ofvarious medical services and clinical health care, despite these economic and geographicbarriers.

(. ave the time wasted by both providers and patients in traveling from one geographic locationto another to avail services on time- %hin& of a patient who re)uires immediate specialistconsultancy, and there is no specialist available to cater to him. %his is where e-medicine couldbe utilized for effective healthcare delivery.

3. 3educe costs of medical care < %he ever- rising cost of healthcare is becoming a primeconcern. %he incidental e'penses related to patient care, i.e. the cost associated with factorsother than the actual medial care such as travel, accommodation for relatives, food etc also

contribute substantially to the overall cost of treatment. 5n a country where health insurance isyet to catch up, all these are borne by patients, in many cases by selling property andlivestoc&. 5f hospitals can reduce these costs associated with treatment, it would go a long wayin reducing the burden of care on the patient. 1-medicine seems to be the answer.

5nitiatives taken by healthcare organi+ations6

%here are many activities that are going to contribute to the spread of 1-2edicine in 5ndia. fwhich +LL !yderabad and 5 !13% 9(40%54 Bangalore are emerging as &eyplayers. 2adras 2edical #ollege is the first government medical college to have 1-2edicine installedin 5405.

rganizations such as 53, have ta&en innovative approach to facilitate healthcare deliveryby launching an e'clusive health satellite. 5t provides almost ;==> uptime, ma&ing it the best medium


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for a country such as 5ndia with diversity in terrain. ?eneral 1lectric and Wipro are also underta&ing e-medicine stations in #hennai and !yderabad.

7rudges and Hindrances

@ /erspective of medical practitioners$ 0octors are not fully convinced and familiar with e-medicine. %hey cannot understand how their obs can be performed more effectively andefficiently through the use of e-medicine. %he very thought of diagnosing a patient whenhe/she is physically absent ust on basis of the data provided through the net turns themblue. imilarly practitioners in remote areas feel threatened that they will be surpassed duethe reach of brand names li&e +LL, sia !eart 9oundation etc.

@ /atients8 fear and unfamiliarity $ %here is a lac& of confidence in patients, about theoutcome of 1-2edicine. %he main problem is that any treatment consist of two factorsA firstis chemotherapy i.e. treatment by medicines and the other is psychotherapy that meanstreatment by emotions which is absent in e-medicine.

@ inancial unavailability$ %here has been several isolated initiatives from variousorganizations and hospitals for the implementation of e-medicine proects. But thetechnology and communication costs being too high, ma&e it financially unfeasible.

@ 9ack of basic amenities 5n 5ndia, nearly => of population lives below the poverty level.Basic amenities li&e transportation, electricity, telecommunication, safe drin&ing water,primary health services, etc. are missing. ny technological advancement can:t change abit when a person has nothing to change.

: 9iteracy rate and diversity in languages$ nly CD.EF > of 5ndia:s population is literatewith only G> well-versed in 1nglish. o the rest of the people are facing a problem inadopting 1-2edicine. lso, the presence of a large number of regional languages ma&esthe applicability of a single software difficult for the entire country.

@ $echnical constraints $ 1-medicines supported by various types of software andhardware, still needs to mature. 9or correct diagnosis and pacing of data, we re)uireadvance biological sensors and more band-width support.

@ ;uality aspect $ 7Huality is the essence8 and every one wants it, but can sometimes createproblems. 5n case of health care, there is no proper governing body to form guidelines inthis respect and motivate the organizations to follow, it is solely on organizations how theyta&e it.

@ 7overnment Support %he government has limitations and so does private enterprises.ny technology in its primary stage, needs care and support. nly the government has theresources and the power to help it survive and grow. But in 5ndia we are not the favoredones. %here is no such initiatives ta&en by the government to develop it.

@


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$he importance of right strategy planning- * specific approach for each case

/rovide basic facilities- li&e %ransportation, 1lectricity, +rimary health care centers +!#etc.

5ntegrate "-1edicine with other daily facilities- li&e 1ducation, !ealth, Ban&ing services etc. $raining- it is essential to train the literate people from rural areas.

ood and "ffective advertising campaigns- by video or by audio, which can beunderstood by rural people.


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$echnical -

# (ser-friendly technology li&e ?raphical (ser 5nterface.# 9le'ibility and adaptability in terms of technology.# 5nvolving the user from the beginning of proect.# Huality control and proper standardizations.# 2a&ing e'pert systems to help users as well as patients.

Social and /olitical -

#ctive participation of society.# trong political will.# 5nvolve 4? volunteers with these activities.

"ducational -# +roviding continuous 2edical 1ducation #21 for users li&e doctors.# %raining programs for health care professionals, patients and other persons.

inancial=

# %he government has limitations and so does the private sector. combined effort from both isneeded. 5n private sector- software, hardware companies, computer education institutes andcorporate hospitals can play a maor role in it.

0onclusion %o witness a successful revolution in 1-medicine, we need to bring these array of activities together. 5fthese e'periments wor& in 5ndia over the ne't decade, the vast population living in developingcountries will be winners and bear the fruit of our success.

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11d e Medicine