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Telemedicine
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- 2. INTRODUCTION Advances in telecommunicationand technologies are revolutionizing education and health services globally, including the provision of nursing services. Decreasing time and distance, these advances increase access to health and health care, especially to underserved populations and those living in rural and remote areas. They help to manage the demand for services, ensure more effective use of human and health resources and facilitate education and research activities. First setup of telemedicine Boston Logan Airport to Massachusetts General Hospital in 1967. Dr. Jay Sanders father of telemedicine, MD President and CEO of the Global Telemedicine Group. It is a phase first coined in the 1970s by Thomas bird, referring to health delivery where physicians examine distant patients through the use of telecommunication technologies.
- 5. MEANING - TELEMEDICINE •Means “distance healing”. • Derived from a Greek word “Tele” meaning “distance” and a Latin word “mederi” meaning “to heal”. • Telemedicine is the future of global healthcare. • Telemedicine is rapidly developing application of clinical medicine where medical information is transferred through the phone or the internet and sometimes other networks for the purpose of consulting, and sometimes, remote medical procedures or examination.
- 6. DEFINITION - TELEMEDICINE “Thedelivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information and communication technology for exchange of valid information for diagnosis, treatment and prevention of diseases and injuries, research and evaluation, and for continuing education of healthcare providers, all in the interests of advancing the health of individuals and their communities.” (WHO)
- 7. DEFINITION - TELEHEALTH •The term telehealth includes a broad range of technologies and services to provide patient care and improve the healthcare delivery system as a whole. • Telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services. • According to the World Health Organization, telehealth includes, “Surveillance, health promotion and public health functions.”
- 8. DEFINITION - TELENURSING Telenursing refers to the use of technology for delivering nursing care from a distance. As technologies like multimedia, imaging, and telecommunications have advanced and become more affordable, tele nursing has become more and more feasible. Its primary benefits are reduced costs, improved quality of care, and the ability to see more patients more efficiently.
- 9. HISTORY 1. Telegraphy andtelephony was established 1920s 2. Wireless / Radio 1950s 3. TV 1960s 4. Computer and Internet 1990/2000 • University of Nebrastea did first documented use of visual telecommunication in health care in 1959. • First internet based telemedicine trials wall conducted in April 1955 when a Chinese studies zee Ling who was studying in Beijing University fell sick and her condition could not be diagnosed in china.
- 11. WHERE IS TELEMEDICINEIS USED?
- 12. TELEMEDICINE IN INDIA •Telemedicine practice was initiated at Luck now and Chennai at 1997. • The first unit of telemedicine was established at medical college Trivandrum, kerala in 2003 • The first Ayurveda telemedicine center was established in India in 2007 by Dr. Partap Chauhan, Director of Jiva Ayurveda, and a well-known Indian Ayurvedic doctor. • ISRO Telemedicine programme started in 2001. Network covers various states/regions including Jammu & Kashmir, Ladakh, Andaman & Nicobar Islands, Lakshadweep Islands, North Eastern States and other mainland states.
- 13. TELEMEDICINE IN INDIA •Presently, the Telemedicine network of ISRO covers about 384 hospitals with 60 specialty hospitals connected to 306 remote/rural/district/medical college hospitals and 18 Mobile Telemedicine units. The Mobile Telemedicine units cover diverse areas of Ophthalmology, Cardiology, Radiology, Diabetology, Mammography, General medicine, Women and Child healthcare.
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- 15. OBJECTIVES • To improvingpatient outcomes • To increasing patient engagement and satisfaction. • To improving patient convenience • To reduced the burden of traveling. • Saves the time of physicians and Patient both. • Saves cost for both the physician and patient. • Reducing hospital readmissions and cost of medical care. • Improving specialist efficiency. • Providing access to new specialties. • Provides a 24/7 quality health services
- 16. AIMS • To deliverspecialized medical care and advice within reach of patient at distant places. • To enhance healthcare delivery. • To increase access to medical specialty services while decreasing healthcare costs • To encourage physicians, nurses, and other healthcare professionals to establish and retain practices in underserved rural areas. • To encourage students from rural communities into the healthcare professions . • To improve public health in rural communities by providing current information and training. • To increase and promote the use of telecommunications for distance learning in health care.
- 17. TYPES OF TELEMEDICINE Realtime (synchronous) Store and Forward (asynchronous)
- 18. REALTIME (SYNCHRONOUS) • Itcould be as simple as a telephone call or as complex as robotic surgery. • Requires the presence of both parties at the same time. • E.G. : Video-conferencing equipment • There are also peripheral devices which can be attached to computers or the video-conferencing equipment which can aid in an interactive examination. • For instance, a tele- otoscope allows a remote physician to 'see' inside a patient's ear; a tele- stethoscope allows the consulting remote physician to hear the patient's heartbeat
- 19. Robotics Remote Surgery Live Monitoringvia Cell Phones
- 20. STORE AND FORWARD (ASYNCHRONOUS) •Store-and-forward telemedicine is also called “asynchronous telemedicine.” • It is a method by which healthcare providers share patient medical information like lab reports, imaging studies, videos, and other records with a physician, radiologist, or specialist at another location. • Does not require the presence of both parties at the same time. • Teleradiology, the sending of x-rays, CT scans, or MRIs (store-and- forward images). • It is particularly popular for diagnosis and treatment with certain specialties including dermatology, ophthalmology, and radiology.
- 21. REMOTE PATIENT MONITORING •Remote patient monitoring, or “telemonitoring” is a method that allows healthcare professionals to track a patient’s vital signs and activities at a distance. • It is often used for the management of high-risk patients, like those with heart conditions and people who have recently been released from the hospital. • It is also extremely useful for the treatment of a number of chronic conditions.
- 22. MOBILE HEALTH ORM-HEALTH • M-Health uses mobile communications devices, such as smartphones and tablet computers, and hundreds of software applications for these devices, which can do almost anything imagined for supporting healthcare.
- 23. APPLICATION ADOPTED • Mostbeneficial for populations living in isolated communities and remote regions and is currently being applied in virtually all medical domains. • Useful as a communication tool between a general practitioner and a specialist available at a remote location. • Telepathology • Telecardiology • Teleradiology • Telesurgery • Teleopthalmology
- 24. Telemedicine Application Home Care and Ambulatory Remote Consultation and Critical Care Monitoring Medical Education andPublic Awareness Second Opinion Telementored Procedure/ Robotic Surgery Disaster Management
- 25. TELEMEDICINE DEVICE OUT PUTDEVICE STORAGE DEVICE VEDIO CONFERENCING
- 26. Wi-Fi Smart Scale Otoscope Blood Pressure Monitor Bluetooth Stethoscope BloodGlucose Meter Digital Thermometer
- 27. Low or smallbandwidth. Unstable electricity supply. Financial unavailability Patient fear . Government support. Diversity in language. BARRIERS OF TELEMEDICINE/ TELECOMMUNICATION
- 28. TELEPHONE NURSING • Telephonenursing care is one application of telehealth. • This is defined as the practice of telephone based nurse- client communication for the delivery of professional nursing services over distances. • As in all nursing encounters, telephone nursing care involves the establishment of a therapeutic nurse-client relationship facilitated through the nursing process.
- 29. TELEPHONE NURSING CARE CANBE DIVIDED INTO TWO SERVICES 1. Health Advice • To identified health need. 2. Health Information •Sharing information about a health issue.
- 30. GUIDLINE FOR TELENURSING •Nurses and midwives practicing in telenursing shall be registered nurses or midwives. Enrolled nurses involved by telenursing need to be under the supervision of registered nurse or midwife. • Nurses and midwives should inform consumers of the telehealth process including other persons/professionals who may be participations or presence is the telehealth consultations and urban consent before proceeding. • Nurses are midwives in televisions have a duty to provide privacy and confidentiality in all interactions. • Nurses and midwives practicing telenursing should engage in evaluation of their practice in relations to issue of quality safety and patient outcomes.
- 31. CHALLENGES OF TELEHEALTH Payment •Payment parity — reimbursement/recoupment and coverage for telemedicine services comparable to those of in-person services is a big challenge for telehealth. Misdiagnosis • Misdiagnosis happens often in in-person health care, but the risks increase with telehealth. • Misdiagnosis has the potential to drive up overall costs to the general health care system as well, because misdiagnoses leads to wrong prescriptions and treatments.
- 32. CHALLENGES OF TELEHEALTH WidespreadImplementation The challenges of widespread implementation of telemedicine encompass many different areas, because “telehealth” can refer to so many different things — from robotics to telephone consultations Telehealth Vendors Vendors are integral to the process, but they are not held responsible nor are they compensated for individual cases
- 33. LIMITATIONS TO SPREADOF TELEMEDICINE • Poor patient – Doctor Relationships • Patient Acceptance • Fear of Technology • Low Rates of Utilization • Infrastructure • Decrease face– face interaction. • Security of data. • Increase liability. • Risk of decreasing quality of care. • Concerns with maintaining confidentiality. • Likelihood of technology failure. • Dehumanizing effects. • Knowledge base of nurse. • Inability for patient to use equipment. • Malfunctioning of equipment