The Archway . . . to Telemedicine
What is Telemedicine?. . . the use of electronic information and communications technologies to provide and support health care when distance separates the participants.
Institute of Medicine, 1996
TelemedicineBackgroundApplicationsBenefits and ChallengesResearchConclusionsRecommendations
The evidence suggest that the conceptdates to 1924.
Quadrants DefinedST/SPSame Time/Same PlaceDT/SPDifferent Time/Same PlaceST/DPSame Time/Different PlaceDT/DPDifferent Time/Different Place
Who is involved with telemedicine?
Telemedicine Applications1. Remote Consultation2. Remote Monitoring 3. Remote Education 4. Telementoring
1. Remote Consultation
Video Clip #1
1.b. Telemedicine for Children with Disabilities
2. Remote Monitoring
Video Clip #2
2.b Access to Information
3. Remote Education
Video Clip #3
Video Clip #4
Whendo we use telemedicine?
When do we use telemedicine?Maldistribution of health resources urban and/or ruralCapitated populationsAccessDistance/Time/TravelPatients and FamiliesOutreach PhysicianIsolation of ProviderNational/International
When do we NOT use telemedicine?
Telemedicine Benefits and ChallengesIt is an amazing invention, but who would ever want to use oneRutherford Hayes, 1882 on the using telephone for the first time
TrendsMarket place reform/managed careShifting site of care Hospital>Clinic>HomeCase Management/Team CareImproved communications between provider and patientHealth care practices and affiliationsDigital convergence
Benefits Patient PerspectiveAccess: Time, Travel, ExpenseHealth Provider CollaborationEnhanced CommunicationsTV & Computer Applications common and non-threateningAdded attention may enhance confidence that all that can be done is being done
BenefitsProvider PerspectiveCommunication/Collaboration with specialistsER front-line supportCME/Life Long LearningSaves time, travel to outreach clinics
ChallengesLack of reimbursementLicensing and Credentialing issuesLiabilityPrivacyInfrastructureEnd-user Issues
RecommendationsConduct a comprehensive telemedicine audit/assessmentExplore Financial Issues Develop a short, mid and long range telemedicine planBuild training initiativesSystematic implementation of plan
Audit and AssessmentMedical Services DataDescriptive elementsCurrent ServicesCurrent technologiesService Opportunities/NeedsMiscellaneous Observations/Comments
Financial IssuesProgram BudgetsFinding FundsMaximizing InvestmentsMeasuring Intangibles
The PlanClarifying GoalsPrioritizing ObjectivesPolicies and ProceduresOperational IssuesPersonnel
Training is essential!
Video Clip #5 : A Typical Telemedicine System
Mere Vehicles Telemedicine and information technologies are mere vehicles that permit the delivery of health care services but which have no greater impact on health care than the truck that delivers our groceries has on our nutrition. It is the content of the vehicle that permits effective health care, not the vehicle.