body top image
Health Care: Delivery, Education, Communication

Telemedicine Systems and Telecommunications

(continued)


6. Information Display

The method of information display will depend mainly on the format in which the information is originally captured. For example, audio information will usually be 'displayed' in the form of sound. Several options are available for displaying images. Videoconferencing units commonly use standard TV sets as their display, while still images are often displayed on PC monitors. However, PC monitors are sometimes used instead of TV screens for viewing video, and TV screens are sometimes used for viewing the output from a PC. This is more than a matter of simply connecting them together, because PC display monitors and TV screens operate in a fundamentally different way (see Squibb for a review).[22]

Many items of medical equipment have a PC built-in, the output of which can be directly displayed on another PC but not viewed with a TV. In such cases, it may be necessary to use a specific video output (often designed for connection to a video recorder) to acquire an analogue signal suitable for a TV display. Such PCs do not always use bulky cathode ray tubes, but increasingly use flat screen displays (as in laptop computers). These types of display are still expensive, but are becoming increasingly popular due to their smaller overall size and lower power consumption. PC screens also come with different resolutions (the number of dots per unit area). High-resolution screens are used for detailed work, but are more expensive. Most telemedicine applications (other than radiology and pathology studies) do not need high-definition images. For instance, a standard magnetic resonance image (MRI) has a resolution of 512 x 512 pixels.

7. Training

Equipment and the telecommunications are a necessary, but not sufficient, prerequisite for a successful telemedicine programme. The right people are also required and they must be properly trained. Since many telemedicine programmes often begin incrementally, training users can also be done incrementally. Numerous universities and private companies offer telemedicine training, as well as the equipment vendors, although this sort of training tends to focus on the capabilities of specific devices. If you decide to implement a telemedicine programme, training must be part of the plan.

8. Conclusion

About 10 or 15 years ago, the technology for telemedicine was not readily available. Much early telemedicine work involved modification of expensive equipment, which was originally designed for other purposes. Now, however, the technologies such as robust telecommunication networks and video equipment are widely available, and much more affordable. Telemedicine users now have a plethora of choice. Most manufacturers offer products that adhere to industry standards which ensure interoperability with other devices. The situation in medical informatics is less developed and efforts continue to ensure the seamless integration of data between different systems. This is important in health care, where patient data-sets need to be available when required.

While the right technology is essential for a successful telemedicine programme, it is essential not to overlook the human factors. In particular, a local 'champion' will be required, and there will be a continuing requirement for user training.

Contact

Brett Harnett
Center for Surgical Innovation
University of Cincinnati
231 Albert Sabin Way
SRU Suite 1566
Cincinnati, OH 45267-0558, USA
Fax: +1 513 558 3788
Email: brett.harnett@uc.edu


REFERENCES

  1. Hailey D, Ohinmaa A, Roine R. Study quality and evidence of benefit in recent assessments of telemedicine. J Telemed Telecare 2004;10:318-24.
  2. Mair F, Whitten P. Systematic review of studies of patient satisfaction with telemedicine. BMJ 2000;320:1517-20.
  3. High WA, Houston MS, Calobrisi SD, Drage LA, McEvoy MT. Assessment of the accuracy of low-cost store-and-forward teledemnatology consultation. J Am Acad Dermatol 2000;42:776-83.
  4. Hoijtink EJ, Rascher I. Telemedicine training & treatment centre 'a European rollout of a medical best practice'. Stud Health Technol Inform 2005;114:270-3.
  5. Garfield MJ, Watson RT. Four case studies in state-supported telemedicine initiatives. Telemed J E Health 2003;9:197-205.
  6. McLendon K. Electronic medical record systems as a basis for computer-based patient records. J AHIMA 1993;64:50, 52, 54-5.
  7. Schadow G, Russler DC, Mead CN, McDonald CJ. Integrating medical information and knowledge in the HL7 RIM. Proc AMIA Symp 2000;764-8.
  8. Taylor P. A survey of research in telemedicine. 1: Telemedicine systems. J Telemed Telecare 1998;4:1-17.
  9. Vassallo DJ. Twelve months' experience with telemedicine for the British armed forces. J Telemed Telecare 1999;5:117-18.
  10. Lian P, Chong K, Zhai X, Ning Y. The quality of medical records in teleconsultation. J Telemed Telecare 2003;9:35-41.
  11. Rosser Jr JC, Bell RL, Harnett B, Rodas E, Murayama M, Merrell R. Use of mobile low-bandwidth telemedical techniques for extreme telemedicine applications. J Am Coll Surg 1999;189:397-404.
  12. Della Mea V, Puglisi F, Forti S, et al. Expert pathology consultation through the Internet: melanoma versus benign melanocytic tumours. J Telemed Telecare 1997;3:17-19.
  13. Kirby B, Lyon CC, Harrison PV. Low-cost teledermatology using Internet image transmission. J Telemed Telecare 1998;4:107.
  14. Johnson DS, Goel RP, Birtwistle P, Hirst P. Transferring medical images on the World Wide Web for emergency clinical management: a case report. BMJ 1998;316:988-9.
  15. Stålberg E, Stålberg S. Regional network in clinical neurophysiology, tele-EMG. In: Wootton R, ed. European Telemedicine 1998/99. London: Kensington Publications, 1999:101-3.
  16. Samedov RN. An Internet station for telemedicine in the Azerbaijan Republic. J Telemed Telecare 1998;4:42-3.
  17. Reponen J, Ilkko E, Jyrkinen L, et al. Digital wireless radiology consultations with a portable computer. J Telemed Telecare 1998;4:201-5.
  18. Freedman SB. Direct transmission of electrocardiograms to a mobile phone for management of a patient with acute myocardial infarction. J Telemed Telecare 1999;5:67-9.
  19. Paul NL. Telepsychiatry, the satellite system and family consultation. J Telemed Telecare 1997;3:52-3.
  20. Macedonia CR, Littlefield RJ, Coleman J, et al. Three-dimensional ultrasonographic telepresence. J Telemed Telecare 1998;4:224-30.
  21. Lamminen H. Mobile satellite systems. J Telemed Telecare 1999; 5:71-83.
  22. Squibb NJ. Video transmission for telemedicine. J Telemed Telecare 1999;5:1-0.

FURTHER READING

  1. Maheu MM, Allen A, Whitten P. E-Health, Telehealth, and Telemedicine: A Guide to Start-up and Success. San Francisco: Jossey-Bass, 2001.
  2. Dodd AZ. The Essential Guide to Telecommunications. Upper Saddle River, NJ: Prentice Hall PTR, 1999.
  3. Radiological Society of North America. A Non-Technical Introduction to DICOM. See http://www.rsna.org/practice/dicom/intro/ (last checked 1 February 2005).

page 1 | page 2 | page 3 | page 4 | top  

filler image
body bottom image