Term Paper of anmc

7/28/2019 Term Paper of anmc

1/5

Introduction

Telemedicine is composed of the Greek word (tele) meaning 'far' or 'at a distance' and

the word 'medicine'.[7] Generally, it is referred to as the use of telecommunications to

provide medical information and efficiency in delivering health services to remote

patients.\cite{istepanian} It may be as simple as two health professionals discussing a caseover the telephone, or as sophisticated as using satellite technology to broadcast aconsultation between providers at facilities in two countries, using videoconferencing

equipment or robotic technology.[3]

The rise in the use of mobile phones coupled with the immense developments in wireless

technology has become an essential part of different domains especially in the field ofmedicine.[7] Recent mobile technologies like 3G data services can allow real-time voice andvideo conferencing which can provide a number of benefits in the medical field. This paved

way to a new technology called Mobile Telemedicine.

Developing a mobile telemedicine infrastructure could help improve the traditional record

keeping system of medical professionals. The system provides efficiency in recordingmedical data with the use of advanced wireless technologies and web services. Portablegadgets such as PDAs, laptops and mobile phones synchronized with other peripheral

attachments are utilized and connect with servers to achieve real-time communication withmedical professionals. This feature becomes of cricumstantial importance when emergenciesand the need for immediate care and consultation arises.

In the Philippines, mobile phones have become an everyday essential for millions of people.

In fact the Philippines is known to be the text capital of the world, with at least 200 millionstext messages sent everyday.[11] In the year 2005, 32.9 million Filipinos owned mobile

phones. According to the study made by the United Nations Conference on Trade andDevelopment, about two out of every five Filipinos has a mobile handset.[6] This represents

how Filipinos are at ease with this technology and how this technology is assured of itslongevity in the typical Filipino's everyday life.

Only around 3.5 million Filipinos use the internet through personal computers according tothe United Nations Conference on Trade and Development [1]. Compared to the totalpopulation of Filipinos of 80 million, this figure doesn't seem much. Comparatively speaking,

owning a computer would entail at least 3 times as much money one would allot for a

mobile phone. Of course today, owning a computer wouldn't be of much use if one did nothave internet access. This just adds to the cost of owning computers.

Mobile phones are a reasonable luxury any Filipino could own. It provides instant andreliable connectivity to the community through its various features such as text and

multimedia messaging, infrared, bluetooth, wap, and 3G. In today's fast-paced

environment, most people would prefer to have gadgets that are portable yet do notsacrifice the quality of service it provides. It is thus safe to conclude that mobile phones fitbest into all of these demands.

Telemedicine in the Philippines

According to [10], telemedicine in the country is used mainly for education, more

particularly in post-graduate studies, and teleconsultation purposes. Some institutes that


2/5

use such field of study are the UP Open University, UP College of Public Health, and

Advanced Science and Technology Institute of the Department of Science and Technology(ASTI-DOST).

These organizations use telemedicine in their fields of study and work. Some of the places in

the Philippines, more particularly in Mindanao, use a local telemedicine infrastructure. This

was made possible with the utilization of telephone lines, audioconferencing kits,speakerphones, and others. However, these places are still in the process of developing and

improving their telemedical application systems. Funds for the project are provided byforeign sources and the Department of Science and Technology.[10]

Mobile Telemedicine

Mobility has become a factor determining the feasibility of telemedicine. Thus, the immense

developments in wireless technology coupled with efforts to find innovative uses for it invarious fields, especially in the medical domain, comes Mobile Telemedicine.[7] Through thisnewly emerging field, wireless technologies could be used to provide communications for

different telemedical applications. The idea behind this involves communication between

doctors, other medical personnel and patients separated geographically. It aims to decreasemedical errors and improve the accuracy of data as it allows real-time access to medical

information like patient data, charting records, drug references, ordering of equipment and

therapies. It can also decrease the time needed for verifications and reports, thereforeallowing personnel to perform more tasks.[3]

Some Issues on Mobile Telemedicine

Here are some issues that Mobile Telemedicine Systems face:

AccessibilityThe application provides instant acquisition of real-time data so accessibility to

remote, isolated, and confined patients is not an obstacle. Through this, healthcareproviders could study their patients' cases even if they are kilometers away fromeach other. They could access their information through this application. [10]

Data Quality and Acquisition

The quality of the data being sent and retrieved is also one of the major issues in

mobile telemedicine.[10] The quality of the link that connects the server and theapplication which delivers the data to and from the application is considered as a

challenge.[5] Also, data acquisition could be hassle especially if the healthcare

provider use a manual (pen and paper) record keeping of patient information.Security

Security should also be included as one of the major features of the application since

the reliability and quality of patients' information that are stored are dependent on

this. [7]Cost

Some gadgets with advanced features used in mobile telemedicine are expensive,such as personal computers or laptops. Also, the travel time of going to the hospital

to access patient information could somehow add to the cost. [10]

Proposed Telemedicine Framework


3/5

Issues to Consider

Security : Telemedicine involves exchange of information that passes through thenetwork, thus, security is considered as one of the major issues in telemedicine. The

application must provide a secured input, access, and storage of data.

Data Reliability and Quality : Data that is sent and received via network must bereliable and of best quality. Since the network does not always provide a securedlink, there might be a possible loss of some data during the network transfer.

Accessibility : Network accessibility is also considered an issue since some remoteplaces are unreachable by some network providers.

Proposed System Framework

System Features

The proposed mobile telemedicine infrastructure is a system which highlights the following

features to solve the issues mentioned.

Easy to use interface on both mobile phones and web applications : Thesoftware must have an easy to use interface on both the mobile phones and webapplications for the user.

Portability and Efficiency : Mobile phones are more portable and easier to carrycompared to laptops and desktop computers. Nowadays, these devices that could be

used to access information through the web. In this case, web services will be usedin the application. Web services are independent platforms which is compatible on

any system. Java-made programs, which will be used to develop the software, couldbe installed in these devices.

Cost and Time : Cost and travel time could be reduced since medical practitionerscould access the medical information of their patients remotely and they don't have

to go to the hospital or clinic to study or access their patients' information or case.Also, most mobile phones are equipped with modern technology applications that

could also be seen in a desktop computer. These devices are also cheaper in priceand compared to desktop computers and laptops.

Data : The application should be able to access rich data such as text, image, audio,and video to and from the web. The link that should be used in retrieving and storing

data must be capable of fast transmission of information through the web.
http://telemedicine.wikidot.com/local--files/chapter-3/application_model


4/5

Discussion Proposed Solutions The group proposed the following solutions to resolve the issues stated previously.

Since the project vies to become an alternative to the traditional pen and paper

method of record keeping, the application must be as simple as possible to use and

navigate through. Clear and simple menu items are lined up on screen andstereotypical navigation commands are placed on the bottom corners of the screen,similar to other mobile applications. Simple designs on the interface also contribute

in making the mobile application pleasing to the eyes. Security of data transmission and storage assures information integrity. After input

of patient information for example, the application encrypts the data first before

transmitting it across the network. When it reaches the database, only encryptedinformation is stored so even the database administrator cannot decipher the data.Upon information request, the encrypted data is sent from the server to the mobile

client. It is only in the mobile application that the data is decrypted for the user toview the actual data requested.

One of the main challenges that the application aims to solve is for the doctors tobring with them patient records without difficulty. Selecting mobile phones overother devices to carry the software gives medical professionals nationwide coveragein 3G services provided by their telecommunication company. This enables the useraccess to patient records anytime, anywhere.

Challenges Records contain the general information, notes, and medical history of patients and

is thus important in consultations and referrals. Bringing stacks of files can be aninconvenience in travelling. In addition to this, files can be easily shuffled if not

handled carefully. Bringing a desktop computer or a laptop can lessen problems in

record keeping, however carrying these devices can become troublesome since theyare quite bulky and must be transported with care.

A mobile phone would be a lot more convenient to bring and use as compared to alaptop. Though mobile phones are significantly less powerful than laptops, they are

powerful enough to contain and operate the software. Laptops on the other hand,can perform as well or even faster but with connectivity restrictions that mobile

phones do not have. Moreover, laptops carry with them excess "software baggage"

that the user doesn't need in record keeping. Mobile phones provide internet access,which enable the use of web services through 3G, a feature that their more powerfulcounterpart cannot perform when located in areas devoid of broadband internet

connection, or even telephone lines at that. Mobile phones are handy yet powerfuldevices that can perform several tasks. The primary use of these devices is forcommunication, in addition to this, mobile phones are also capable of storing variousapplications for entertainment, organization, and customization.

The proposed mobile telemedicine project aids physicians and medical practitionersin bringing expertise to remote areas such as barrios. The group faces various

challenges in the development process. Mobile phones have limited memorycapacity. This means that only a limited amount of data could be stored in mobiledevices. Thus, a remote database is needed. This is accessed through web services.Network problems could be encountered because of possible intermittent fluctuations

in the network and limited coverage in some remote areas. [Bibliography

item chu not found.] Also, simultaneous transmission of information in the internetcould also affect the speed of the transmission flow. In the Philippines, accessingthese information in the network through the 3G network owned by telephone

companies automatically entails an extra cost for the user.


5/5

After project development is done, testing is important to determine operation issuesand errors. The server would be hosted by the Java Research and Development

Center, located in the UP Ayala Technopark. Sample data with different experimentalcontrols would be run by the group to catch potential problems, errors and test the

reliability and efficiency of data transfer. Mobile phones with 3G capability, whichserve as the client, would be packaged or installed with the software for testing in

the actual environment the software was designed to operate in. Once project development and testing is done, it is important to gauge the success

of the project. One of the major criteria for this is user acceptance. A shortevaluation could be given to the doctors. These contain questions that pertain to the

measure of aethestics of the interface, the ease of inputting the data, manipulation

of the software. The willingness of these medical professionals to use this newtechnology compared to the conventional files in paper is pivotal as well.

Benchmarking measures with regards to the speed of transfer of data from the

server to the client and back would also be considered as a criteria.

Current Status The project is still in its development stage. So far, majority of the features have

been completed. The project involves the development of a web page, where theuser inputs their unique web username, password and serial number of the mobile

phone, which will come into play later. The midlet has a user login which checks the

web username, password and serial number during the user's initial use of thesoftware. The second part of the login asks for the username and password on themobile phone (which is stored in the record manager). A successful login, switches

the screen to a menu where the user can search for a patient, configure the settings,

and a help option. The features that are included are adding and editing patientinformation, cases and multimedia features such as recording and retrieving images,

audio and video files. All of the information inputted from the phone, is encrypted

before passing it to the server, and the database. All data should be encoded usingthe a hash code encryption algorithm.

The group is currently working on the development of creating and retrieving mediaapplications for different data representations (such as image, audio, and video),improvement of the application design, and the development of the web services.

Further Work Among the issues to be considered in the project is security. At present the group

plans to implement a hash function to encrypt the data before being transferredacross the network. Stronger methods of encryption would be recommended forfuture development since the quality of data is important especially in the field of

medicine.

Other features could be added to the application as well, if the project is furtherimproved in the future. Generated graphs for ECG, blood pressure and other body

function measures could be sent with the attachment of peripheral devices for inputin the mobile phone.

Documents

Term Paper of anmc