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THE ROLE OF TELEMEDICINE
1R.SaiNikhila, Geetha S
2
1UG Students,
2Assistant Professor
Department of Biomedical Engineering
BIHER, BIST, Bharath University
Chennai- 6000073.
geethas.bme @bharathuniv.ac.in
ABSTRACT:
The term “Telemedicine” is the delivery of medicine at distance. It is composed of the
Greek word τελε (tele) meaning 'far', and medicine. Telemedicine uses communication
and electrical-electronic devices for the delivery of clinical consultation .It is a simple
tool where two or more health specialists discuss a case over a telecommunicating device,
such as telephone or a mobile phone ,satellite technology and video-conferencing
equipments to conduct a real-time consultation in two different countriesto which travel
is not easier.
Care at a distance, is an old practice which was often conducted via post
which - thanks to modern communication technology - has metamorphosed into modern
telemedicine. Telemedicine is most beneficial in isolated communities and remote
regions used in all domains of medicine.It is also useful as a communication tool between
a general practitioner and a specialist available at a remote location.
The exponential growth of the internet in recent years has led to a dramatic
increase of the world-wide availability of digital information services. While file transfer
(FTP service) and electronic mail (E-mail services)were instrumental in promoting the
idea of global information exchange .
The terms e-health and telehealth are at times wrongly interchanged with
telemedicine. Telemedicine refers only to the clinical services while telehealth can refer
to clinical and non-clinical services such as medical education, administration, and
research. The term e-health includes telehealth, electronic medical records, and other
components of health IT.
International Journal of Pure and Applied MathematicsVolume 119 No. 12 2018, 11577-11592ISSN: 1314-3395 (on-line version)url: http://www.ijpam.euSpecial Issue ijpam.eu
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TYPES OF TELEMEDICINE
Telemedicine is also useful as a communication tool between a general practitioner and a
specialist available at a remote location. It is categorized into two types: real
time(synchronous) and store-and-forward(asynchronous).[1-6]
Real time telemedicine is like a telephone call.It requires the presence of both
parties at the same time and a communications link between them that allows a
real-time interaction. Video-conferencing equipment is one of the most common
form used in synchronous telemedicine. There are also peripheral devices
attached to computers or the video-conferencing equipment which help in the
interaction. 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.[7-10]
Store-and-forward telemedicine involves acquiring medical data ( biosignals etc)
and transmitting this data to a doctor or medical specialist at a convenient time for
assessment offline. It does not require the presence of both parties at the same
time.The information is stored initially and transmitted when required.
Telemedicine is used to bridge the gap between a general practitioner and a specialist
available at a remote location.
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TELECOMMUNICATION AND ITS EQUIPMENTS :
Telecommunication is the communication at a distance using equipments
such as cables,fibre optics etc.,There are devices used to transmit, receive and amplify
signals.These include Modem,signallers,coders,decoders,amplifiers and receivers.[12-14]
The Signalers and Receivers are easy to install and can be used individually or
together. These are designed to allow you to add more signalers as your needs change.
International Journal of Pure and Applied Mathematics Special Issue
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These signalers plug directly into the telephone line then alert you when you receive a
call. Compatible with individual signalers, the Remote Receivers receive the signals in
different patterns to make it easy to tell which signaler has sent the transmission . There
are various models of signalers and receivers such as LT, LTD, LR, LRD.[15-19]
In this block diagram, the transmission of signals has been described. Connecting one
telephone to another and to different stations involve a few communication devices. The
MUX is the multiplexer to which many inputs can be provided while we can select our
desires output in the end.It selects one out of many data and outputs that source into a
single channel for a greater efficiency. The telephone lines are connected to he MUX
which is attached to a modem
A MODEM is a device used to modulate and demodulate the input signals. The signals
obtained by the MUX are modulated so that the satellite accepts them and sends the
amplified output. Once the central station is reached the signals are transmitted to the
desired stations where again a MODEM demodulates and sends the message to the
stations. The modem actually carries a carrier message along with our message.[20-24]
International Journal of Pure and Applied Mathematics Special Issue
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Telecommunication infrastructures support information movement among
geographically dispersed locations. The pathway a given telemedicine program will
utilize is determined by required capabilities and available infrastructures. The bandwidth
(bits per second) of the transmission medium limits the types of telecommunication
systems that can be used. [25-27]
Telemedicine mobile communication and wireless portal
Secure hosting as an Applications Service Provider.
Secure hosting as an Applications Service Provider.
2G+, 3G and IP-enabled external connectivity.
Real-time transactions between back-end systems and Internet-based
communication services, portals, and applications, as well as front-end
applications.
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Managed connectivity and integrated application services that help bring
physicians, patients, hospitals and their healthcare community partners on-line
together. Once connected, Telemedicine then provides an integrated suite of
clinical and administrative services that enable more effective communication and
collaboration throughout the healthcare community.
VoIP (Voice over IP) and Media over IP technology. Real time conversation over
the internet between patient and physician for situations where data transmission
is necessary and essential. For example, a physician can remotely describe the
medication to patient while writing and signing the prescription over the internet.
Digital wireless transmission
Our 50GHz digital wireless transmission system is able to utilize the point-to-point
communication on the place where we can not settle wire cable easily.[28-30]
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By applying the system, you can settle network for sending image and data easily.
2 types of amplifier product lines for Base Stations. One is the Indoor Transmitting
Amplifier Units. The other is the Outdoor Receiving Amplifier Units. The Indoor
Transmitting Amplifier Unit is settled in the base station cubicle and it amplifies
transmitting multi carrier with low distortion.[31-36] The Outdoor Receiving Amplifier
Units are designed to set outside and connected with antenna feed. By settling it so,
system can amplify down link signal with low noise and low distortion. Normally Base
stations are settled on the roof top of buildings or ground.
TELEMEDICINE ACHIEVES
New clinical needs for computerized communication are created by fundamental
changes in the health care systems of some European countries that require from
physicians cost confinement, assessment of medical quality and provisions for an
improved continuity of care. This modern technology has tied up the rural communities
to doctors in cities. [37-39]
A man with chest pains in a small village on the Yukon River was supervised. A
community health aide sent an electrocardiogram to a supervising physician of
Fair banks. Within minutes the man was diagnosed with a serious heart condition.
Appropriate therapy was mobilized.
A 10-year-old girl was seen by an audiologist who took a picture of her ear drum
in Nome and sent it to an ear specialist in Anchorage. Later that day, the
otolaryngologist diagnosed her with a cholesteatoma and scheduled surgery to
avoid hearing loss in the child.
International Journal of Pure and Applied Mathematics Special Issue
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TELEMEDICINE AND CARDIOLOGY
Considering the first case where the electrocardiogram plays a role, it is
necessary to link such a medical equipment to a good system of telecommuniction
devices, to get the proper output signal of heartbeats and diagnose perfectly.The ECG
converts the heart beats into electrical pulses. It involves 10 sticky electrodes placed
on the surface of our body without any pain. When this equipment is connected to
other devices like coder, decoder, amplifier, these electrical impulses are obtained in
the form of waves... [40-42]
. A wave of normal heart beat is compared with the defaulted one and the
problem is diagnosed. The use of telemedicine in this is that if the patient and the
physician are in two different places or countries, the problem could still be checked
constantly and reports could be sent.[43-45]
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About 18 million people in the United States had heart problems. Reports
indicated that 15% of persons with heart attacks developed heart blocks during the course
of their lifetime.This is a serious complication in heart that leads to more than 70% of
attack related lower extremity amputations. The annual Medicare cost for care in patients
with such complications was 3 times that of the normal patients .[17-21]]
A regionally based heart care program (HCP) was established in Baton Rouge,
LA, to provide specialized heart care and prevent lower extremity amputations in the
public hospital system.
Many rural residents, medically underserved as a result of economic and
geographic barriers, inhibited their ability to travel long distances to the state public
hospitals for care. More than 20,000 patients with blocks were cared for by the Louisiana
hospital system; many lived between 50 and 300 miles from the LSUHSC heart care
program. Telemedicine played a vital role to solve the problem.
A number of descriptive studies found store-and-forward digital images,8-10
video phones using audio and still images,11-12 and real-time 2-way video13 as useful
approaches in the evaluation, management, and reduction of costs14 of lower extremity
amputations.The store-and-forward transmission of digital images and real-time video
conferencing were efficient methods for a home care nurse treating patients with such
problems because it allowed the nurse to coordinate and track the progress of
patients.[26]
International Journal of Pure and Applied Mathematics Special Issue
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The use of real-time, interactive telemedicine consultations between a home
health nurse providing wound care and a remote wound care specialist may improve
wound care. In a descriptive report of 120 home care medical records of patients with
pressure, venous stasis, the number of treatment visits, weeks to healing, wound-related
hospitalizations, and wound care costs were lower after implementation of telemedicine
consultations. [31-39]
TELERADIOLOGY
This mode of telecommunication has contributed to the field of medicine in various
means.Three essential components involved are, an image sending station, a transmission
network, and a receiving / image review station.
The teleradiology process begins at the image sending station. The radiographic
image and a modem are required. The image is scanned and then sent to the
modem.The transmission network can be wire, fiber optics, or microwave.
After the digital information has been sent to the modem, electrical impulses are
sent along to the transmission network to the receiving / image review station.
The receiving / image review station consists of a modem, a computer with
sufficient storage capabilities, a TV monitor, and sometimes a printer to provide
hard copies to the end user. [30-37]
The electrical impulses created through the transmission network are received by
the modem on the review station. These impulses are converted back to the
original digital image once it reaches the review station. This image is then stored
and can be viewed on the TV monitor for diagnostic purposes. A hard copy can be
printed for more convenience.
The teleradiology process can be connected in many ways.
A point-to-point connection consists of a sending station that is connected to a
review station via a transmission network. This connection allows viewing from
one location in a building to another.
International Journal of Pure and Applied Mathematics Special Issue
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A Local Area Network(LAN) connection is when there are many sending and
review station connected through a transmission network. This type connection
allows images to be viewed in several different locations in a building.
A Wide Area Network(WAN) connection is when many Local Area Networks
are connected to one another to create a way for images to be viewed in different
far off places.
RESULT AND INTERPRETATION
Telemedicine can serve patients in many ways, from interacting with cardiologists or
psychiatrists over a video conference call to monitoring chronic diseases in a patient's
home, such as mental disorder or congestive heart failure. Cardiology has already widely
embraced telemedicine. Electronic stethoscopes can facilitate the transmission of heart
sounds to far off places using telecommunication devices. Echocardiograms,
ultrasonographic images,electrocardiograms and other images can be readily transmitted
to different countries and evaluated effectively.s
Health care professionals can remotely monitor patient’s vital signs,pulmonary
heart functions and communicate with the patients via telephone,computer or television
monitor.This has helped enable the patient to remain at home while monitoring
congestive heart failures or metabolic stability.
Effective teleradiology has developed extensive standards of how images should
be stored and transmitted to ensure accurate representation. Radiology reports are
forwarded easily by using secure , low bandwidth systems. The implications for
providing high quality radiology services are immense.
Emergency vehicles are often enhanced by onboard computer systems that use
Geographic Information Services Technologies to direct ambulances to the patient by
using satellite coordination, software programs, and wireless communications.
International Journal of Pure and Applied Mathematics Special Issue
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