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  • 1. Telehealth and Telemedicine
    • Jayantha U. Weerasinghe (Faculty of Dental Sciences, Peradeniya)
    Academic Sessions - SLMA and Ruhuna Clinical Society - 2002
  • 2. Telehealth and Telemedicine
    • Telehealth
    • Telemedicine
    • exchange of material offline
    • Real-time (online) image transfer
    • commercial software available
    • SAGA and Peradeniya Activity
  • 3. Telehealth
    • Telehealth is using technology to provide medical care over distance
    • non-clinical services such as distance medical education and research
    • It will allow information to be received by remote centres
  • 4. Telemedicine
    • Telemedicine typically involves medical personnel using   images, video and audio facilities either non-real-time (off line) or real-time (on line) for remote consultations. 
    • An expert physician far away can guide the local medical personnel in treatment planning remotely
  • 5. Telemedicine exchange of material offline
    • Store and Forward method
    • Local physician sending digital images of pictures, x-rays, and other patient information directly to the computer of a specialist.
    • After reviewing that information, the specialist then sends the diagnosis back to the local doctor, who treats the patient and provides follow-up care.
  • 6. Telemedicine - non realtime store and forward method
    • Usage
    • Teleradiology
    • Telepathology
    • Teledermatology
  • 7. Telemedicine- non realtime store and forward method
    • Advantages
    • Minimum resources needed
    • Regular email attachments could be used
    • Disadvantages
    • Time delay in response
    • Limitation of image quality and size
    • Cross checking and feedback will take more time
  • 8. Telemedicine real-time (online) image transfer
    • Exchange of high quality still images, video clips between the remote center and   the experts using videoconferencing equipment.
    • experts outside will be able to guide the remote center in realtime
  • 9. Telemedicine : real- time
    • Advantages
    • Used in many areas of medicine, surgery, dentistry
    • accessibility of expert help in remote areas
    • Saves time of an expert in frequent travel to remote areas
    • permits Continuing Education and training for practitioners in remote areas
    • Disadvantages
    • Non availability of appropriate technology and adequate bandwidth in the network
    • Lack of funds for equipment and software
    • Lack of technical help
  • 10. Basic requirements
    • Requirements :
    • Videoconferencing equipment
    • A Digital Video (DV) camcorder ( IEEE1394 interface)
    • OR Digital camera with USB connection
    • microphone and speakers
    • Desktop/ Laptop computer
    • Internet access - leased line/ Local Area Network
    • Dedicated software
  • 11. Shortcomings of commercial software
    • Eg:- Messenger. CuSeeMe, Netmeeting,, freetalk,
    • Poor quality of images at low speed networks
    • not suitable for medical collaboration activities
      • image manipulation, tele-pointing facility on the image canvas, shared-board
    • clinicians would prefer a user-friendly operating environment specifically designed for medical applications.
  • 12. Sri Lankan Experience of high quality medical image and voice transfer through internet Between Medical School & Faculty of Engineering SAGA University-Japan And Faculty of Dental Sciences - Peradeniya Department of Oral Surgery Faculty of Dental Sciences, University of Peradeniya
  • 13. Previously used method - Store and Forward
    • Images of patients- photographs and radiographs were exchanged
    • Non real time method
    • Disadvantages -
      • Delay in receiving and responding
      • Delay in decision making at the remote centre since they await advice from the expert outside
      • limitations of commercial email software for sending large data files
  • 14. SAGA Medical School SAGA University (Engineering) Faculty of Dental Sciences- Peradeniya jp /education/project/Collabo1.asp
  • 15. Realtime image transfer using a dedicated software
  • 16.  
  • 17. Dedicated Software developed by SAGA
    • Connections made by ‘dialing’ IP address
    • Voice transfer full duplex
    • Image transfer with following facilities
      • Sender and receiving windows
      • Shared board facility for image canvas
      • Accessing shared files on each computer
      • Transfer of powerpoint presentations and playback
      • Recording facility of the images received
      • User-friendly
  • 18. Software Overview
    • Image transmission
    • Voice transmission
    IP Preview Transmit Receiving windows Shared Board WEB File transfer Transmit from Remote centre Receiving from Expert centre abroad
  • 19. Software Overview
    • Transmission of Video as a Series of JPEG Images
    • interactive full-duplex voice
    • Image quality and image rate can be adjusted
    • User Friendly Graphic User Interface
    • Shared Board Facility
  • 20. Shared Board Facility
    • Both parties can use markers on the same image canvas
    • Allow common base for discussions
    • Text typing facility
    Marker from expert Marker from local team
  • 21. WEB Facility
    • File transfer facility
    • Powerpoint presentations can be transferred and run as a lecture from the remote location
    • Ideal tool for CME
  • 22. Advantages of the System
    • Eeconomical and freely available components,
    • Operated in both low speed and high speed networks
    • User-friendly easy to install and operate
    • image software has a Graphical user interface customized for medical personnel with facilities such as shared board, transmitting powerpoint files and multiple image windows.
  • 23. Application of the technique
    • Between Faculty of Dental Sciences Peradeniya and SAGA Medical School
    • An interactive session for JICA trainees in SAGA was conducted
  • 24. Application of the technique locally
    • Tested between Faculty of Dental Sciences Peradeniya and
    • Faculty of Medicine Peradeniya
    • Genetics Unit, Faculty of Medicine-
      • University of Colombo
    • Community health and Family Medicine -
      • University of Kelaniya
  • 25. Summary
    • System developed for Real-time Telemedicine which has been tested locally with a dedicated software designed in JAPAN
    • It is suitable for low speed networks
    • It could be used for Information exchange and Continuing Education sessions
    Telehealth and Telemedicine
  • 26. Thank You!
    • Japan
    • Professor Nobumichi Sako - former President of Saga University
    • Mr. Minoru Tanaka - Chairman of NetCom Saga Association
    • Venture Business Laboratory (VBL) - Saga University
    • Prof Takeshi Katsuki - Oral & Maxillofacial Surgeon,
    • SAGA Medical School
    • Sri Lanka
    • Prof N A de S Amaratunga - Dean, Faculty of Dental Sciences, Peradeniya
    • Dr. Nimal Ratanayaka- Director of the Internet/communication unit, Faculty of Engineering, Peradeniya
    • Dr Toru Nagao- JICA Chief Advisor, Faculty of Dental Sciences
    • Mr. Ranjith Abeyratne- Technical Officer, Faculty of Dental Sciences
    • Dr Kumara Mendis - Dept of Community Medicine and Family Health Faculty of Medicine, University of Kelaniya
  • 27.