Chapter 23: Wireless Internet in Telemedicine
Kevin Hung and Yuan-Ting Zhang
23.1 Introduction
23.1.1 Definition of Telemedicine
The term telemedicine consists of two parts. The first part, "tele," means "at a distance," so basically telemedicine is the practice of medicine at a distance. The evolution and emergence of various communications technologies, such as the telephone, television, computer network, and wireless communication, have been enhancing the feasibility and diversity of telemedicine applications over the past few decades. Hence, the meaning of telemedicine also is being refined as time goes by.
One of the current definitions of telemedicine is as follows:
Telemedicine involves the use of modern information technology, especially two-way interactive audio/video telecommunications, computers, and telemetry, to deliver health services to remote patients and to facilitate information exchange between primary care physicians and specialists at some distance from each other. [1]
Some might have come across the term "telehealth" and wonder what this has to do with telemedicine. Telemedicine can be considered a subset of telehealth. According to the World Health Organization (WHO), telemedicine is oriented more toward the clinical aspect, while telehealth is generally the delivery of health care services at a distance. [2]
23.1.2 Areas of Telemedicine Applications
There are two modes of operation for telemedicine: real-time and store-and-forward. [3], [4] In real-time mode, the information, which can be any combination of audio, images, video, and data, is transmitted to the remote terminal immediately after acquisition, thus allowing real-time interaction between patients and health care personnel. Some examples are consultation with a remote doctor, ambulatory electrocardiogram (ECG) monitoring, and instant transmission of ultrasound images. Because real-time applications involve continuous, time-critical information exchange, high transmission bandwidths are often required, resulting in relatively high operation cost.
In store-and-forward mode, the acquired information is viewed or analyzed at a remote terminal at a later time, so it is less demanding in bandwidth. Diagnosis and clinical management are the main applications of store-and-forward telemedicine. [5] Some examples of these are transfers of previously recorded ECG and computer tomography (CT) scans. Table 23.1 shows some areas of telemedicine.
| Telemedicine Applications | |
|---|---|
| Teleradiology | Telepsychiatry |
| Telepathology | Telecardiology |
| Teledermatology | Tele-homecare |
| Teleoncology | Tele-surgery |
| Remote patient monitoring | Teleconsultation |
23.1.3 The Need for Telemedicine
Why do we need telemedicine? Obviously, it is the only way to deliver medical services in cases of emergency in remote, isolated areas where no medical professional is present. Immediate medical advice received at the patients' side of a teleconsultation system would be valuable and would save lives. Many countries do not lack medical facilities; instead they face the problem of uneven distribution of these resources. This problem has triggered the development of telemedicine systems for sharing resources between areas. Such systems not only can reduce cost, but also can eliminate the need for patients or health care staff to travel. For example, many hospitals today are already using a picture archiving and communication system (PACS) and a hospital information system (HIS) for information exchange between hospitals and clinics. [6]
Another motivation for telemedicine development is the world's aging population. The number of persons aged 60 years or older is projected to be almost two billion by 2050, and it will be the first time in human history that the population of older persons will be larger than that of children (0 to 14 years). [7] These statistics have triggered the United Nations to discuss many social development issues related to meeting the specific needs of the elderly, including requirements for health care. [8] The prevalence of chronic conditions among the elderly is generally higher than among younger persons. [9], [10] Because symptoms for chronic illnesses tend to be more subtle and vague, recognition and diagnosis of disease in the elderly requires a high degree of alertness. From these it can be seen that telemedicine applications such as home-based teleconsultation and patient monitoring would definitely be useful in health care support for the large elderly population.
23.1.4 Chapter Overview
The following sections of this chapter include a brief history of telemedicine and a review of how Internet-based telemedicine emerged. Some past and current telemedicine applications based on wireless Internet are then described, along with a recent example in detail. Finally, issues in practicing telemedicine with wireless Internet are discussed.
[1]Bashshur, R.L., Telemedicine and the health care system, in Telemedicine: Theory and Practice, Bashshur, R.L., Sanders, J.H., and Shannon, G.W., Eds., Charles C Thomas, Springfield, IL, 1977.
[2]Darkins, A.W. and Cary, M.A., Telemedicine and Telehealth: Principles, Policies, Performance, and Pitfalls, Springer, New York, 2000.
[3]Lin, J.C., Applying telecommunication technology to health-care delivery, IEEE Eng. Med. Biol. Mag., 18 (4), 28, 1999.
[4]Craig, J., Introduction, in Introduction to Telemedicine, Wootton, R. and Craig, J., Eds., Royal Society of Medicine Press, Glasgow, 1999.
[5]Craig, J., Introduction, in Introduction to Telemedicine, Wootton, R. and Craig, J., Eds., Royal Society of Medicine Press, Glasgow, 1999.
[6]Huang, H.K, PACS: Basic Principles and Applications, John Wiley & Sons, New York, 1999.
[7]United Nations, World Population Ageing: 1950–2050, United Nations Publications, New York, 2001.
[8]United Nations, The World Aging Situation: Strategies and Policies, United Nations Publication, New York, 1985.
[9]Kart, C.S., Metress, E.K., and Metress, S.P., Human Aging and Chronic Disease, Jones and Bartlett, London, 1992.
[10]Timiras, P.S., Ed., Physiological Basis of Aging and Geriatrics, CRC Press, Boca Raton, FL, 1994.
EAN: 2147483647
Pages: 239