THE ROLE OF TELEMEDICINE · Greek word 20 0 (tele) meaning 'far', and medicine . Telemedicine uses...

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.

International Journal of Pure and Applied Mathematics Special Issue

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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.


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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]


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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.


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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]


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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.


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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.


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THE ROLE OF TELEMEDICINE · Greek word 20 0 (tele) meaning 'far', and medicine . Telemedicine uses...

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