Telemedicine uses electronic information and telecommunications technologies to provide remote clinical healthcare and support health education. It has various applications including videoconferencing, transmitting patient images and data, remote patient monitoring, and continuing medical education. Telemedicine provides benefits like improved access to specialists for remote/rural patients, cost savings from reduced travel, and continued education for doctors. However, challenges include persuading doctors and patients to adopt it, infrastructure and connectivity issues in rural areas, the costs of technology and communications, and legal issues around licensing and liability.

1. Telemedicine and its application
in public health
Dr. Preeti Tiwari

2. Contents
•Introduction
•Objectives
•History
•Supports
•Why it is relevant to our society
•Benefits to health care professionals
•Benefits to patients
•How it can be used?
•Major challenges

3. INTRODUCTION
• “Tele” is a Greek word meaning “distance “
• “mederi” is a Latin word meaning “to heal”
• “healing by wire”

4. TELEMEDICINE
• The use of electronic information and
communications technologies to provide and
support health care when distance separates the
participants.
• Telemedicine, Telehealth, mHealth, Telecare

5. • Telemedicine has a variety of applications
 Patient care
Education
Research

6. Videoconferencing
Transmission of still images
 E-health
 Remote monitoring of vital signs
 Continuing medical education
 Nursing call centers

7. Types of technology

8. Definations

9. Telemedicine
• The delivery of healthcare services, where distance is a
critical factor, by all healthcare professionals using
information and communication technologies for the exchange
of valid information for diagnosis, treatment and prevention of
disease and injuries, research and evaluation and for the
continuing education of healthcare providers, all in the
interests of advancing the health of individuals and their
communities

10. Telehealth
• Telehealth is the use of electronic information and
telecommunications technologies to support long distance
clinical healthcare, patient and professional health-related
education and training, public health and health
administration.

11. Telemedicine Specialty Centre
• Telemedicine Specialty Centre is a site, where the specialist is
present. He can interact with the patient present in the remote
site and view his reports and monitor his progress.

12. • Thirty years.
• The National Aeronautics and Space Administration
(NASA)
• NASA’s efforts in telemedicine began in the early 1960s
• Its goals is to provide healthcare to astronauts in space
History

13. • In 1989, NASA conducted the first international telemedicine
program
• Telemedicine consultations were conducted using oneway
video and voice technologies between a medical center in
Yerevan, Armenia and four medical centers in the US

14. India
• The Apollo group of hospitals
• Pilot project at a secondary level hospital (Aragonda 16 km
from Chitoor )Andhra Pradesh.

15. • Web cameras and Integrated service digital network (ISDN)
telephone lines
• Videoconferencing system

16. • The Sriharikota Space Center project (130 km from Chennai)
• Which formed an important launch pad of the Indian Space
Research Organization in this field

17. Telemedicine

18. ObjectivesObjectives
• Information management
– Patient information
– Medical data (signs, symptoms, test reports, etc..)
– Appointment scheduling
– Archival and retrieval of patient records
• Low cost solution
– Using ordinary telephone line

19. • Service to large population
– Through public health care delivery systems
• Development of knowledge-based system
– For decision support
– For training and education

20. Supports
In India, telemedicine programs are being actively supported
by:
• Department of Information Technology (DIT)
• Indian Space Research Organization
• NEC Telemedicine program for North-Eastern states

21. • Apollo Hospitals
• Asia Heart Foundation
• State governments

22. Why it is relevant to our society
• Poor infrastructure
• Non-availability of experts (disparate distribution)
• Lack of proper medical education

23. • Low doctor-patient ratio (large population)

24. • Patients have accepted telemedicine :-
 Pilot program study finds pediatric obesity patients like
telehealth services
– UCLA – December 2013

25. Benefits to Healthcare Professionals
Click to add Title1 Improved diagnosis and better treatment managementImproved diagnosis and better treatment management1
Click to add Title2
Continuing education and trainingContinuing education and training
2
Click to add Title1 Quick and timely follow-up of discharged patientsQuick and timely follow-up of discharged patients3
Click to add Title2 Access to computerized comprehensive data ofAccess to computerized comprehensive data of
patientspatients
4
1

26. Benefits to patients
• Access to specialized health care services to under-servedAccess to specialized health care services to under-served
rural, semi-urban and remote areasrural, semi-urban and remote areas
• Early diagnosis and treatmentEarly diagnosis and treatment
• Reduced physician’s fees and cost of medicine
• Reduced visits to specialty hospitalsReduced visits to specialty hospitals

27. • Reduced travel expenses
• Early detection of disease
• Reduced burden of morbidity

28. How it can be used?

29. Specialist referral services
• Typically involve a specialist assisting a general practitioner
in rendering a diagnosis.
• Involve a patient “seeing” a specialist over a live remote
consult
• The transmission - diagnostic images / video along with
patient data to a specialist for viewing later.

30. Images

31. Vector Data

32. Graphics

33. Video Clip

34. Direct patient care
• Sharing audio/video / medical data between a patient and a
health professional .
• Rendering a diagnosis, treatment plan, prescription or advice.
• This might involve patients located at a remote clinic, a
physician’s office or home.

37. Remote patient monitoring
• Uses devices to remotely collect and send data to a monitoring
station for interpretation.
• “home telehealth” applications
 Devices to capture a specific vital sign, such as blood pressure,
glucose, ECG or weight.
• Supplement the use of visiting nurses.

39. Medical education and mentoring
• Provision of continuing medical education
• Special medical education seminars
 Targeted groups - expert advice provided
 Medical procedure.

40. Consumer medical and health
information
• Includes the use of the Internet for consumers to obtain
specialized health information
• On-line discussion groups to provide peer-to-peer support.

41. Data for patient management in TelemedicineData for patient management in Telemedicine

42. Structured DocumentStructured Document

43. Different types of services
 Telecardiology
 Teleradiology
 Telepathology
 Telepsychiatry
 Early Warning System
[ Prevention and control of endemic and infectious
diseases ]

44. Different online services
Mobile apps

45. Wearables

46. Available soon
Wi-Fi Smart Scale Otoscope Blood Pressure Monitor
Bluetooth Stethoscope Blood Glucose Meter Digital
Thermometer

47. Robotics
Remote Surgery
Live Monitoring via
Cell Phones

48. Challenges
• Perspective of medical practitioners:
 Doctors are not fully convinced and familiar with e-medicine.
• Patient’s fear and unfamiliarity:
 Lack of confidence in patients about the outcome of
e-Medicine.

49. • Financial unavailability:
 The technology and communication costs being too high,
sometimes make
 Telemedicine financially unfeasible.
• Lack of basic amenities:
 Nearly 40% of population lives below the poverty level.
 Basic amenities -are missing

50. • Literacy rate and diversity in languages:
 Only 65.38% of India’s population is literate
 Only 2% being well-versed in English.
• Technical constraints:
For correct diagnosis and pacing of data-
 advanced biological sensors
 More bandwidth support.

51. • Government Support
• Poor Data Communication Infrastructure.
• A Large Population Catered by Government Hospitals.
• System Features should be scalable
• Cost of the system should be scalable.
• Neither telephone lines nor electricity in rural areas

52. • Satellite transmission can help but is pricey
• Unstable electricity supply.
• Longer time for data transfer.
• Poor video quality

53. Legal issues
 licensing, registration, authorisation of health professionals
 liability
 personal data protection

54. Thank you