TelemedicineThis is a featured page

What is it?
Telemedicine is "the diagnosis and treatment of patients in remote areas using medical information, as x-rays or television pictures, transmitted over long distances, esp. by satellite" (Dictionary.com). This system uses various software to connect a remote area to a more populated one and allows medical professionals to seek the advice of other professionals who may have more experience or a specialty in a certain field they do not have.

When patients at Martha’s Vineyard Hospital in Massachusetts were supposed to have a Stoke, their case was practically hopeless. Because of the few number of residents and even fewer number of medical specialists who reside at the hospital, doctors were not able to know how to diagnose the patients. In addition, Martha's Vineyard Hospital only has an MRI machine (used in diagnosing a stroke) come in by ferry once each week. It cannot be available on a moment's notice and the cost of providing that kind of care is too much for the town to afford. The treatment for strokes is a medicine called tPA. However, this medicine causes potentially fatal bleeding in the brain in about six percent of people who use it. Without knowing if the patient truly did have a stroke, doctors simply cannot take the risk and give them tPA. This problem is what forced the hospital to sign up for a telemedicine program called TeleStroke.

TeleStroke is a program offered by two Harvard teaching hospitals located in Boston. For only ten thousand dollars telemedicineeach year (as opposed to the millions of dollars it would cost to have an MRI machine and the necessary medical specialists on had to diagnose stroke patients) Martha's Vineyard Hospital uses image-sharing and videoconferencing technology to link to the Harvard hospitals. This allows neurologists at the Harvard hospitals in Boston to examine the patients at Martha's Vineyard Hospital and assist emergency room doctors in deciding whether or not to give tPA. Even though Martha's Vineyard Hospital only has x-ray and CT scan machines, the experienced doctors are often able to make a decision they feel quite confident about based on their experience with stroke patients.

What are the IT components?Telemedicine - The ITGS Wiki at BHS
  • Videoconferencing: digital technology that allows for people in two different locations to talk and see each other through a video camera and television screen that plays what the camera records; allows people in two different locations to communicate, almost as if they were in the same room
  • Image-sharing software: allows people in two different location to easily share images, usually via the Internet; this allows doctors in one location to share x-rays and CT scans with specialists in another location

What are some advantages?
  • Cost: though telemedicine may cost a lot of money, it is cheaper for small towns compared to the cost of hiring the specialists and paying them to sit and wait for patients, as they would be doing most of the time
  • Better decisions: with the input from other specialists, doctors are able to make better decisions
  • Globalization: people in all areas of the world now are able to receive up to date medical advice through IT. The cost of the technology, though, still poses some problems.
What are some disadvantages?
  • Security: as with most technology, it is impossible to secure telemedicine systems so that no one will be able to access the communication accept the intended person
  • Uncertainty: it is difficult to know the correct person has been contacted or if an image is simply showing
  • Reliability of Software: It is impossible to rely on the software...IT systems often stop working
  • Transmission issues: what if something goes wrong in transmission? What if the quality is bad?
What are the social/ethical issues?
  • Security: as was discussed in disadvantages, keeping the IT system secure is next to impossible
  • Privacy and anonymity: when someone comes into the emergency room, the ER staff may not think about whether or not they wish to have their picture broadcasted to another hospital. If they do not, their privacy should be respected...then how do you get the needed information to know if tPA should be given or not?
  • Reliability: as with most technology, hardware can always stop working. If it stops in the middle of someone giving advise to another on what medicine to administer, this could pose a life-threatening issue, especially if the person receiving the information only knows how to administer th medicine and not make necessary decisions
  • Equality of access: because of the expense of the hardware, setting it up, and finding doctors to use it, it makes this system only practical for rich countries, not third world countries
  • Globalization: Though there is issues with equality of access, if systems could be set up it would greatly improve health care and communication around the world
  • Policies and standards: before the equipment is used, policies and standards must be set up as to who has access to the equipment, who handles it, when it is used, etc.
Sources



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ltryus
Latest page update: made by ltryus , Oct 15 2008, 12:45 AM EDT (about this update About This Update ltryus Edited by ltryus

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