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Telemedicine Training Outline
This training programme is aimed at both health workers who will be using Telemedicine techniques as part of their clinical practice and key support
personnel working in the field of telemedicine or telehealth. It is intended that the training programme will be flexible and modular allowing units to be
selected and combined depending on the participating target group.
Mission
To develop a workforce with a practical working knowledge of Telemedicine and competence in the ethical use of Telemedicine and Tele-education.
Objectives
By the end of the Training the participants should be able to competently:
Access and search for information on the internet
Send and receive emails (including attachments)
Take and forward high quality digital photographs
Demonstrate the ability to perform basic picture editing
Demonstrate skill in the use of digital scanning equipment
Demonstrate skill in the use of a document camera
Use programs such as Skype or similar VOIP software
Apply various techniques involved in synchronous telemedicine
Apply various techniques involved in store and forward telemedicine
Understand how to design and set up a telemedicine consultation venue
Understand how to design and set up a tele-education videoconference venue
Understand how to use and troubleshoot videoconferencing equipment
Be able to set up point to point and multipoint videoconference using ISDN, IP and mixed ISDN and IP links
Demonstrate the use of video camera technology, camera placement, lighting, angles and framing.
Demonstrate an understanding and the use of; microphone technology; the range of available microphones; microphone set up; and solving audio
problems associated with videoconferencing.
Understand the use of peripheral diagnostic equipment (tele-stethoscopes, ophthalmoscopes, dermascopes, ENT scopes, hand-held cameras and
ultrasound probes)
Demonstrate skill in use of peripheral diagnostic equipment (tele-stethoscopes, ophthalmoscopes, dermascopes, ENT scopes, hand-held cameras
and ultrasound probes) where appropriate
Apply any Telemedicine activity according to relevant ethical and clinical guidelines
Demonstrate an understanding of ethical issues relating to telemedicine
Demonstrate an understanding of ethical issues relating to the practice of telemedicine
Demonstrate an understanding of relevant local and regional legislative issues
Demonstrate an understanding of financial and administrative issues relevant to the practice of telemedicine in their region
2
Pre-requisite
A basic level of computer literacy (see outcomes listed in unit 1). If participants do not meet these basic criteria – the pre-module Unit 1 has to be
completed.
Teaching Methodology
A mixture of information sessions / lectures and practical sessions
Units
The programme is made up of units, which can be combined depending on the learning needs of the target groups.
The programme also has key strands, which thread through all the modules and require reflection at the end of each module:
- Ethics in Telemedicine
- Computer skills
The units, including the introduction to computing, total up to 21 hours and can be put together to create workshops ranging from a half day to 3 days
depending on the target group and the purpose of the training.
In addition, specialist Telemedicine Units can be made available in the specialist areas of:
Telepsychiatry
Teledermatology
Teleradiology
Ultrasonography
Ophthalmology
3
Unit
Outcomes
Training Strategies
Resources
Unit 1
Introduction to
Computers.
3 hours
Prerequisite: None
On completion of the unit participants will
be able to:
Identify the relevant components of a
computer
Use a mouse
Create a word document
Send an email
Save a document to hard drive
Save a document to a memory stick
Open web browser
Conduct a Google search
Information Session: 1 hour
What is a computer
Basic Internet and email
Basic filing
Basic MS Word
Introduction to the Web
Practical Session: 2 hours
Individual sessions in front of a computer
Activities
Turning on a computer
Do a mouse exercise
Create a word document
Create a folder and file word document
Search for „Telemedicine” on the Web
Print out article
Transfer files to a memory stick
Send an email
PowerPoint Slides
Data projector
Computer
Resource manual
(Intel training disk)
- Computer: 1 per
participant
- Internet access
- email address
- Web browser
- MS Office or
equivalent
- Memory stick
- Intel or similar
training CD
4
Unit
Outcomes
Training Strategies
Resources
Unit 2
Introduction to
Telemedicine
1 hour
Prerequisite:
Unit 1
On completion of the unit participants will
be able to:
Differentiate between telemedicine,
tele-education and teleconferencing
Differentiate between synchronous and
asynchronous Telemedicine
Describe the features of synchronous
telemedicine
Describe the features of store and
forward telemedicine
Identify core obstacles to the
implementation of Telemedicine in
their own country
Identify the cost and administration
implications of Telemedicine
Discuss the requirements of a needs
assessment
Discuss the requirements of programme
evaluation
Information Session: 1 hour
History of telemedicine
Concepts, Definitions / acronyms
Features of synchronous telemedicine
Features of store and forward telemedicine
Types of Telemedicine
Costs and administration
Images, DICOM and PACS
Tele-education
Strengths and Weaknesses of telemedicine – what evidence?
Telemedicine needs assessment
Telemedicine evaluation
Ethics, law and standards as issues
Medical informatics and the Electronic patient record
Specialties: Radiology, Dermatology, Home-based Care,
Ultrasound, Psychiatry
The Future
PowerPoint Slides
Data projector
Computer
Resource manual
5
Unit
Outcomes
Training Strategies
Resources
Unit 3
Ethics and Law in
Telemedicine
1 hour
Prerequisite:
Unit 1
On completion of the unit participants will
be able to:
List and discuss the key ethical issues
in Telemedicine
Identify the relevant Health Legislation
that governs the practice of
Telemedicine
Identify issues relating to international
practice of telemedicine
Information Session: 1 hour
Patient physician relationship
Informed Consent
Confidentiality and privacy
Quality of care
Standards - adequacy and quality of data
Continuum of care
Data security
Liability
Licensure
Record keeping
Protocols
Tele-medical Law
Prescriptions and electronic signatures
PowerPoint Slides
Data projector
Computer
Resource manual
Case studies
Readings
Ethics
Legislation
6
Unit
Outcomes
Training Strategies
Resources
Unit 4
Setting up venues
2 hours
Prerequisite:
Unit 1
On completion of the unit participants will
be able to:
Set up a telemedicine consultation
venue
Set up a tele-education videoconference
(VC) venue
Use and troubleshoot VC equipment
Set up point to point and multipoint VC
using ISDN, IP and mixed ISDN and IP
links
Demonstrate an understanding of: the
use of video camera technology;
camera placement; lighting; angles and
framing.
Demonstrate an understanding of the :
the use of microphone technology; the
range of microphones; microphone set
up; and solving audio problems
associated with VC
Understand the connection of
peripheral diagnostic equipment (tele-
stethoscopes, opthalmoscopes,
dermascopes, etc)
Information Session: 1 hour (In the absence of equipment)
Practical Session: 2 hours
Set up a Telemedicine venue and discuss
o Location
o Access
o Equipment as per small clinic
o Physical characteristics (sound proofing, lighting)
o Equipment (video conference equipment, accessory video-
camera, portable microphone)
o Telemedicine diagnostic equipment
o Room layout
o Connect available tele-diagnostic equipment
o Basic trouble shhoting
Set up Tele-education venue and discuss
o Location
o Access
o Size of target group
o Equipment as per teaching
o Physical characteristics (sound proofing, lighting,
acoustics)
o Equipment (video conference equipment, external
speakers, radio microphones, data projector, audiomixer)
o Room layout
o Basic trouble shooting
PowerPoint Slides
Data projector
Computer
Resource manual
Reading:
Telemedicine & Tel-
education venue
design principles
Equipment
Telemedicine and
Tele-education rooms
- VC equipment,
Accessory video-
camera
- Portable
microphone
- Document camera
- Phone
- Fax
- Computer
- External speakers,
Radio
microphones,
- Data projector,
Audiomixer
- Tele-diagnostic
equipment
7
Unit
Outcomes
Training Strategies
Resources
Unit 5
Basic Telemedicine
Skills - demystifying
the world of
technology.
1 hour
Prerequisite:
Unit 1
On completion of the unit participants will
be able to:
:
Identify the different computer options
available and the relevant advantages
and disadvantages of each
Identify the different kinds of access to
Internet and email available locally
Discuss different communication
options
Discuss the latest ICTs such as mobile
phones, PDAs
Information Session and demos: 1 hour
How do you get access – communication options
o Dial up, broad band, wireless, phone cards, phones
o Modem, LANs, VPN
What skills are needed
Computers
o Desktops vs Laptop vs Tablets vs PC vs Smart Phone
Basic requirements for PCs
o Sound
o Memory
o Monitor
o Resolution
o CD/DVDs
Storage
o Hard drives
o Flash-cards, CD/DVDs
Good Practice
o Back up, Virus protection, Security
mHealth
o Smart Phones
o PDAs
Health Information Systems and Medical Informatics
PowerPoint Slides
Data projector
Computer
Resource manual
Readings
Equipment:
Flash cards
Laptop
Tablets
Smart Phone
PDA
Wired LAN
connection
Wireless connection
3G/GPRS card
8
Unit
Outcomes
Training Strategies
Resources
Unit 6
Basic Skills – Use of
the Internet (1)
1 hour and 30
minutes
Prerequisite:
Unit 1
Unit 5
On completion of the unit participants will
be able to:
Understand how the internet work
Select an appropriate browser option
Access the internet to:
o Do a literature search
o Download software
o Use an IP based educational
software package
Information Session with demos: 30 minutes
Internet history
How the internet works
o Browser options
o Search engines
o Protocols
What is available
o Literature search
o Internet distance learning
o Web pages
o E-learning packages
o Downloading software
o IP based internet educational software (Breeze, Illuminate)
o Blogs
o Future of Internet
Practical Session: 1 hour
Individual activity
Access internet and do the following:
o Do a literature search on Telemedicine on Pubmed,
Google, Google Scholar and Wikipedia
o Do an online educational activity
o View a blog
PowerPoint Slides
Data projector
Computer
Resource manual
- Computer: 1 per
participant
- Internet access
- email address
- web access
- web browser
- sound card
- headphones
- Online Educational
Package loaded
9
Unit
Outcomes
Training Strategies
Resources
Unit 7
Basic Skills – Use of
Email (2)
1 hour and 30
minutes
Prerequisite:
Unit 1
Unit 5
Unit 6
On completion of the unit participants will
be able to:
Set up a web based email address eg.
Gmail
Send an email to another participant
Send an email with an attachment to
another participant
Start a chat conversation with another
participant
Identify the risks and ethical issues of
email communication.
Develop a contact list
Develop a group contact list
Set up email rules
Track the delivery and status of an
Archive emails
Use Skype
Information session: 30 minutes
Service Providers
o Costs
o SMTP and POP
Types of email servers
o Web based vs Outlook vs Express
Use of email
o Contacts and groups
o Attachments & file size (file compression)
o File extensions eg. pdf, jpg, doc etc.
Other communication technologies
o Chat
o VOIP
o Podcasts
Managing emails
o Filing
o Viruses & Security
o Tracking
o Archiving
Practical Session: 1 hour
Set up a Gmail or similar account
Send an email
Compression of attachments
Create a contact list and group
Chat
Set up an email rule for going on holiday
Listen to a podcast
Use Skype to call and chat
PowerPoint Slides
Data projector
Computer
Resource manual
- Computer: 1 per
participant
- Internet access
- email address
- web access
- web browser
- sound card
- headphones
- Skype
- Podcast on server
10
Unit
Outcomes
Training Strategies
Resources
Unit 8
Basic Skills: Digital
photography
Time: 3 hours
Prerequisite:
Unit 1
On completion of the unit participants will
be able to:
Choose a camera for their special needs
Identify the main components of the
camera
Understand different types of memory
Select from a range of file formats
Compress photographs to reduce file size
Edit picture to improve quality
Use a flash when appropriate
Differentiate between optical and digital
zoom
Use the macro feature
Transfer image files from camera to
computer
Use a flat bed scanners
Use 35mm slide and microscope
scanners
Describe the features of the DICOM
standard
Discuss issues related to image size and
quality for radiology
Take a video using a digital camera
Use cell phone to take a photograph
Information Session (1 hrs)
Comparison of digital and film cameras
Considerations when buying a camera
o Budget
o Ease of use
Main Components of a digital camera
Memory and memory cards
Graphic File formats for saving images
File size and image quality
When to use flash
Macro Photography
Optical vs digital zoom
Transfer of images from the camera or memory card to a
computer
Enhancement of images using a computer and graphic software
Storage
Flat Bed Scanners and PDF format
o Advantages of PDF format
Cropping the image or text
35mm slide and microscope slide scanners
DICOM features
Radiology image standards
Video standards
Practical (2 hours)
Small groups (2-3 people )
Activities
Take photographs of each other
Experiment with exposure and lighting
Take close up photographs (Macro )
Copy X-Ray filmPreview pictures in the camera
Transfer images to a memory stick or computer
Basic image enhancement and cropping on a computer
Save an image in DICOM format
PowerPoint Slides
Data projector
Computer
Resource manual
- Computer: 1 per
participant
- Internet access
- email address
- web access
- web browser
- Cameras
- X-Ray Films
- Flat Bed Scanners
- Photo-editor or
similar
- DICOM
conversion
software
11
Unit
Outcomes
Training Strategies
Resources
Unit 9
Practical use of
Store and Forward
3 hours
Prerequisite:
Unit 1
Unit 2
Unit 3
Unit 5
Unit 6
Unit 7
On completion of the unit participants will
be able to:
Using a digital camera, save an image
on a computer and send it as an email
attachment to a consultant at a different
site.
Identify the indications for store and
forward technology
Recognize and address the ethical
issues in store and forward.
Information session: 1 hour
Definition/explanation of store and forward telemedicine
Indications for use.
Special Telemedicine Software
Guidelines / contract for response time
File size (picture image) and compression
Ethics
o Confidentiality
o Security of internet
o Clinical photography
Practical Session: 2 hours
Small groups (2-3 people)
Activities
Take photographs of “skin condition” and a macro of the eye
Save image on computer
Edit and compress picture
Email to given address.
PowerPoint Slides
Data projector
Computer
Resource manual
Equipment
- Computer: 1 per
participant
- Internet access
- email address
- web access
- web browser
- Cameras
- Photo Editor
12
Unit
Outcomes
Training Strategies
Resources
Unit 10
Tele-education
2 hours
Prerequisite:
Unit 1
Unit 2
Unit 3
Unit 5
Unit 6
Unit 7
On completion of the unit participants will
be able to:
Understand the use of teleconferencing
equipment for the use of tele-education.
Demonstrate skill in use of
teleconferencing equipment for the use
of tele-education
Understand the benefits of using Scorm
compliant learning objects
Understand key principles of Learning
Management Systems
Information session: 1 hour
Reasons for using Tele-education
Criteria for Tele-education implementation
Administration models for implementation
Finance models for implementation
Evaluation methodology
Economic evaluation
Change management
Learning management systems
Interoperabilibty – Scorm 1.2
PowerPoint Slides
Data projector
Computer
Resource manual
13
Unit
Outcomes
Training Strategies
Resources
Unit 11
Telemedicine and
homecare
introduction
2 hours
Prerequisite:
Unit 1
Unit 2
Unit 3
Unit 5
Unit 6
Unit 7
On completion of the unit participants will
be able to:
Understand the use of peripheral
diagnostic equipment (tele-
stethoscopes, opthalmoscopes,
dermascopes, ENT scopes, hand-held
cameras and ultrasound probles)
Demonstrate skill in use of peripheral
diagnostic equipment (tele-
stethoscopes, opthalmoscopes,
dermascopes, ENT scopes, hand-held
cameras and ultrasound probes) where
appropriate.
Apply various techniques involved in
the synchronous ans store and forward
telemedicine according to the relevant
clinical guidelines.
Recognise and address ethical issues in
the practice of Telemedicine
(Still to be developed)
