Telemedicine is the transfer of medical data through electronic communication means from one location to another. Due to rapid innovations in telecommunications and computer technology over the years especially in this century, many elements of medical practice can be accomplished when the patients and health care provider are separated geographically. The separation could be way beyond the world to outer space or across the world or states or even across the different zones and districts of the country.
Telemedicine may be as simple as two health professionals counseling over a case ever the telephone or can be as complex as using fiber optics or and satellite communication technology and video conferencing equipment based on H-323, H-239, H-264, H-460 standard costing more than a million rupees for each station to conduct a real time consultation among medical specialists in different countries. In general Telemedicine refers to the use of ICT. Information communication technology to deliver clinical care.
Distance medical care during old clinical practice is also known as Р Р†Р вЂљ�AbsentiaР Р†Р вЂљ� care that used to be conducted via post usually taking weeks to even months. Today due to development in communication technology that information is communicated at electronic speed within our planet and way beyond.
The Royal Flying Doctor service of Australia in the early 19th century used to communicate over the two-way radios powered by a generator driven by a set of bicycle pedals.
Telemedicine began in the early 1960s. The National Aeronautics and space Administration (NASA) played an important role in the early development of Telemedicine. Humans began traveling in space and physiological information of the spaceman were telemetered from spacecraft and space suits during space mission.
In a book by Rashid Bashshur published in 1975 lists fifteen telemedicine projects active during the period in Russia, USA and all over the world, pioneering work in that field had been carried out. Since 1977, Telemedicine center at Memorial University of Newfound Land (MUN) has worked toward developing programs on transmission of medical data among the guidelines followed were to use the simplest and least expensive technology. MUN has been playing an active role in International Teleconferencing in the school of medicine at the university of Nairobi, Kenya linking Nairobi and Kampala through Intelsat in 1985. MUN has been a model for judicious and low cost use of Telemedicine technology.
NASA has conducted the first International Telemedicine program in 1989.
The North-West Telemedicine Project was setup in 1984 in Australia to provide health care to people in five remote towns through satellite. 2/3rd of these people were Aborigines. This project proved that the technology has improved the health care of these remote residents
Types of Telemedicine:
1) Real Time
2) Store and forward.
Real Time Telemedicine can be as simple as telephone call or as complex as robotic surgery, requires the presence of both or all parties at the same time and communication link among them that allows a real time interaction to take place. In real time or synchronous Telemedicine, video conferencing equipments consisting of video camera with audio and computer along with appropriate software that can aid in an interactive examination such as a Tele-otoscope to see inside patientР Р†Р вЂљРІвЂћСћs ear and a Tele-stethoscope allows consulting remote physician to hear the patientР Р†Р вЂљРІвЂћСћs heart beat etc. On line medical consultations are provided in various medical disciplines such as pathology and pharmacy, neurology, gynecology, obstetrics, pediatrics, urology, oncology cardiology, psychiatry, infectious diseases /HIV-AIDS, opthalmology, radiology etc.
Store and forward Telemedicine involves obtaining medical data and transmitting data to a medical specialist at a convenient time for assessment off line. It does not require the presence of both parties at the same time. Tele-dermatology, Tele-radiology and Tele -pathology are common specialties that are conductive to a synchronous Telemedicine. Medical records that are properly structured as per pre-requisite to the software involved in electronic form should be a component for transmitting.
Telemedicine can play a vital role as a communication tool between a specialist and a general practioner. A doctor uses devices to examine remotely to treat a patient and at any given time a specialist can treat many patients located in different locations with the help of Telemedicine devices. A specialist can save lot of his/her time on visiting patients and traveling. A specialist stationed in Calcutta has been treating patients located in Madras, Delhi, Bombay, Trivandrum and some other cities through communication media like broadband, Internet communication and tools like video conference equipments.
In Nepali context today with acute shortage of medical specialists, the patients all over 75 districts can be remotely treated by small number of super specialists using broadband communication media like ISDN, CDMA, ADSL, 3G telecommunication services and video conferencing technology that are already available in Nepal. Perhaps what we lack is a sincere dedication, good
planning and strong urge to serve the patients all over Nepal.