Transcript telemedicine - Nova Southeastern University

The Archway . . . to
Telemedicine
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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
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Telemedicine
• Background
• Applications
• Benefits and
Challenges
• Research
• Conclusions
• Recommendations
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Background
The evidence suggest that the concept
dates to 1924.
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Coldeway’s Quadrants
ST
SP
ST
DP
DT
SP
DT
DP
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Quadrants Defined
• ST/SP
– Same Time/Same Place
• DT/SP
– Different Time/Same Place
• ST/DP
– Same Time/Different Place
• DT/DP
– Different Time/Different Place
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Who…
… is involved with
telemedicine?
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Telemedicine Networks
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Telemedicine
Applications
1. Remote Consultation
2. Remote Monitoring
3. Remote Education
4. Telementoring
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1. Remote Consultation
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Video Clip #1
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1.a Telepsychiatry
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1.b. Telemedicine for Children
with Disabilities
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2. Remote Monitoring
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Video Clip #2
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2.a Collaboration
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2.b Access to Information
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3. Remote Education
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Video Clip #3
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4. Telementoring
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Video Clip #4
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When…
…do we use telemedicine?
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When do we use telemedicine?
•Maldistribution of health resources urban and/or rural
•Capitated populations
•Access
•Distance/Time/Travel
•Patients and Families
•Outreach Physician
•Isolation of Provider
•National/International
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When do we ‘NOT’ use
telemedicine?
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Telemedicine
Benefits and Challenges
“It is an amazing invention,
but who would ever want to
use one”
Rutherford Hayes, 1882
on the using telephone for the first time
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Trends
•Market place reform/managed care
•Shifting site of care Hospital>Clinic>Home
•Case Management/Team Care
•Improved communications between provider and
patient
•Health care practices and affiliations
•Digital convergence
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Benefits
Patient Perspective
•Access: Time, Travel, Expense
•Health Provider Collaboration
•Enhanced Communications
•TV & Computer Applications common and nonthreatening
•Added attention may enhance confidence that all
that can be done is being done
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Benefits
Provider Perspective
•Communication/Collaboration with
specialists
•ER ‘front-line’ support
•CME/Life Long Learning
•Saves time, travel to outreach clinics
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Challenges
• Lack of reimbursement
• Licensing and Credentialing
issues
• Liability
• Privacy
• Infrastructure
• End-user Issues
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Recommendations
• Conduct a comprehensive
telemedicine audit/assessment
• Explore Financial Issues
• Develop a short, mid and long range
telemedicine plan
• Build training initiatives
• Systematic implementation of plan
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Audit and Assessment
• Medical Services Data
– Descriptive elements
– Current Services
– Current technologies
• Service Opportunities/Needs
• Miscellaneous
Observations/Comments
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Financial Issues
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•
•
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Program Budgets
Finding Funds
Maximizing Investments
Measuring Intangibles
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The Plan
• Clarifying Goals
• Prioritizing Objectives
• Policies and Procedures
• Operational Issues
• Personnel
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Training is essential!
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Video Clip #5 :
A Typical Telemedicine System
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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.
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