This document provides information on teleconsultation including its definition, types, examples, and implementation in various medical fields. It discusses two main types of teleconsultation - real-time (synchronous) and delayed (asynchronous). Real-time uses live video conferencing while delayed uses stored digital files sent electronically. Examples provided are telepsychiatry and teleradiology. The document also summarizes teleconsultation networks implemented in radiation medicine, Malaysia, and specific networks for telecardiology, teledermatology, and teleradiology. Finally, it outlines strategies for future upgrades to infrastructure, connectivity speed, software, and devices.

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3. What is Teleconsultation?
❏ It is the one of electronic communications to provide medical
expertise or treatment to areas where the expertise is not
readily available.
❏ There are two type of teleconsultation:
❖ In real-time (synchronous)
❖ Delayed (asynchronous or store and forward).

4. In real time (Synchronous)
❏ Real time teleconsultation uses advanced telecommunication
technology to exchange information and involves the use of
audiovisual technology allowing individuals to communicate
live (or synchronously) over a video conference link.
❏ Real time services require, at a minimum, video cameras, a
sound system, computer displays, and a secure high speed
internet connection to transmit data between sites

5. In real time (Synchronous)
❏ Real time teleconsultation encompasses computer
technologies using narrow and high bandwidths for specific
types of transmission, full motion video, broadcast video,
compressed video and virtual reality.
❏ Real-time services rely on the availability of dedicated video
conferencing facilities, which generally are restricted to
institutions.

6. Example of Real-Time Interaction: TelePsychiatry
❏ A patient is in the video conferencing room of a rural
community telehealth site.
❏ At the same time the patient’s psychiatrist is in the video
conferencing room at the specialist centre for psychiatry.
❏ Live interactive consultation takes place between the patient
and the psychiatrist.

7. Delay (Asynchronous )
❏ Technology can be any device capable of capturing a digital
sample, storing it, downloading it, and transmitting it to a
remote site. Equipment used includes computers and laptops,
computer files, scanners, digital cameras, iPods, audio files,
or text files of a patient’s medical history. The internet
provides the ability to transmit large files securely, quickly,
and inexpensively to almost any location.

8. ❏ Asynchronous teleconsultation has led to shorter wait times,
fewer unnecessary referrals, higher levels of patient care, and
patient and provider satisfaction in remote areas that lack health
care professionals (Deshpande et al., 2008).

9. Example of Store & Forward Interaction: TeleRadiology
❏ In a rural community telehealth site, a patient’s x-ray is taken,
scanned and captured as an electronic file.
❏ The file, and any accompanying medical notes, is sent
electronically to the physician in the tertiary care telehealth
site.
❏ The radiologist in the tertiary care site opens the file, reviews
the x-ray and notes in order to confirm and/or determine a
diagnosis.

10. ❏ The file and accompanying notes are then returned to the
rural telehealth site.
❏ The patient is informed of diagnosis without having to meet
the radiologist.
While Real Time and Store & Forward can be used separately,
they can also be used in conjunction with one another to
further enhance the care provided

11. Teleconsultation in Radiation
Medicine
Consultations between the Health Sciences Centre of the
University of Ulm, Germany and Urals Research Centre for
Radiation Medicine,Chelyabinsk, Russia

12. REMPAN
❏ Installation and regular use of telemedical consultations via
satellite between Ulm and Chelyabinsk based on multimedia
patient records
❏ Improvement of medical care of persons with health effects after
chronic radiation exposure
❏ Standardisation of diagnostic and therapeutic methods.

13. Figure 1: The satellite communication system

14. MMDB
❏ The multimedia medical database(MMDB) has been used for
medical teleconferences.
❏ The MMDB was created to achieve the following purposes:
❏ Preparation and systematization of complete data on
patients
❏ Preview of information by experts on each side before
teleconference
❏ Simultaneous review of information in the MMDB during
videoconferences
❏ Subsequent scientific analysis of clinical data

15. Software and Hardware
❏Software:A multimedia medical database
was developed using the relational database
management system(RDBMS)Oracle 8.0
software package for Window NT 4
operational system.
❏Hardware: Pentium II-266 PC; Pentium-90
Pro PC; Video Controller and an X-ray RSU1 scanner

17. Teleconsultation in Malaysia
❏ It was initiated in 2009 under the auspices of Malaysian Multimedia
Super Corridor Telemedicine Flagship Application and the Ministry
of Health, Malaysia.
❏ A network of nationwide Teleconsultation (TC) was created for the
Disciplines of:
1. Neurosurgery,
2. Radiology,
3. Cardiology
4. Dermatology.

18. Telecardiology
❏ Telecardiology facilitates the remote follow up of patients who carry
a pacemaker. The device sends a flow of information to an internet
server through the GSM network.
❏ This information relates to both the good functioning of the device
and the state of the patient’s heart.

19. Telecardiology network

20. Teledermatology
❏ Teledermatology is a subspecialty in the medical field of
dermatology and probably one of the most common applications of
telemedicine and e-health.
❏ In teledermatology, telecommunication technologies are used to
exchange medical information
(concerning skin conditions and tumours
of the skin) over a distance using audio,
visual and data communication.

21. TeleDermatology Network

22. Teleradiology
❏ Teleradiology is the transmission of radiological patient
images, such as x-rays, CTs, and MRIs, from one location to
another for the purposes of sharing studies with other
radiologists and physicians.

23. TeleRadiology Network

24. Hospital Locations and Disciplines

25. Hardware

26. Strategic For Future
Table 1 :Strategic for future
❏ Upgrading of the Infrastructure
❏ Increasing the connectivity speed
❏ Upgrading the software
❏ Device upgrading