Transcript Telemedicine and e-health

Telemedicine and E-health ICT to make people better more quickly
Dr Jim Briggs
University of Portsmouth
Talk given at the ICT Study Day
7th December 2004
Contents
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Who am I and where do I work?
Definitions
Types of telemedicine
Case studies
E-health
Unanswered questions
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Who am I?
• Dr Jim Briggs
• Principal Lecturer in Information
Systems and Computer Applications
• Leader of the Healthcare Computing
Group
• Director of the UK Telemedicine and
E-health Information Service (TEIS)
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Where do I work?
• University of
Portsmouth
• 30 courses in the
computing/IT field
• Medium-sized university
• Computer Engineering
• Mainly city-centre
• Computer Science
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location
Lots of new student
accommodation
Excellent social life
Excellent study facilities
By the sea
• Software Engineering
• Information Systems
• Animation, Games, ET
• Mobile/wireless
• Website
• http://www.port.ac.uk
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Telemedicine and E-health
Definitions
• Telemedicine:
• medicine at a
distance
• cf television,
telephone, etc.
• E-health:
• health services
delivered
electronically
• cf E-commerce,
E-learning,
E-government, etc.
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Characteristics of tm systems
• Interaction style
• real-time (e.g. videoconferencing)
• store-and-forward (e.g. email)
• Data types
• text (e.g. patient's notes)
• image (e.g. x-ray)
• Equipment
• general purpose (e.g. PCs)
• specialist (e.g. electronic stethoscope)
• http://jhi.sagepub.com/cgi/content/abstract/7/3-4/222
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Case study 1: Cornwall MIUs
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Case study 1 cont.
• Minor Injury Units:
• replacing "unviable" accident & emergency
departments
• nurse led
• deal with "straight-forward" problems
• Linked to central A&E department by
video link to provide expert backup
• http://www.bthealth.com/casestdy/cstudy/case11.htm
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Case study 2: ambulance links
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Case study 2 cont.
• ECG, etc. links from ambulance to hospital
• Expert backup for paramedics
• Reducing "call to needle" time for rural heart
attack patients
• Dundee study reduced average time from 125 to
52 minutes [Pedley et al; BMJ 2003]
• Also, advance warning to A&E staff of details
of incoming cases
• http://www.rcsed.ac.uk/fellows/bcpaterson/chest_pain.htm
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Case study 3: dermatology
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Case study 3 cont.
• Overload on specialist dermatologists - long
waiting lists for referrals
• tds Telemedicine Ltd. provides a commercial
service
• specially trained nurses take digital photos
• specialist software routes to consultant
dermatologists (anywhere in UK) for diagnosis
• consultant can work from home
• tds replaces local consultant but not totally
• http://www.tds-telemed.com/
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Case study 4: WorldCare
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Case study 4 cont.
• Consortium of 4 big American hospitals
• Provide "second opinion" service
worldwide (20 countries)
• tele-radiology
• tele-pathology
• patient management consultation
• Local physician remains responsible
• http://www.worldcare.com/
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Case study 5: NHS Direct
• Biggest telemedicine project in the world
• Mainly telephone service
• Expanding to:
• web
• online diagnosis for common conditions
• health encyclopaedia
• my NHS healthspace (personal info portal): news,
reminders, knowledge
• digital TV
• http://www.nhsdirect.nhs.uk/
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E-health - the future of health?
Making health care more easily
accessible to the patient
The banking metaphor
• Most transactions
carried out by the
customer
• Centralisation of
specialist services
• Decentralisation of
non-specialist
services
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Integration of IT
Integration of IT into
business sectors
Public Services
(Health…)
Business Services
(Banks)
Manufacturing
1980
1990
2000
Jean-Claude Healy
May 2000
IT as a gadget
Trojan horse: networks, …
Full Integration of IT into Business (Organisational, Legal) Re-engineering
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the system
Are hospitals a thing of the past?
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New sources of "health" 1
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New sources of "health" 2
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New sources of "health" 3
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e-health - Busan, S Korea
• Medical Tourism
• 2 hours by air for 2 billion people
• 1% with disposable income = 20 million
• Cardiac - Cancer - Mental Health
• Costs can be competitive
• Popular tourist resort for families
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Some questions left unanswered
Medico-legal/ethical issues
• Who is (legally) responsible for the
patient's treatment?
• What country's laws apply?
• Can a correct diagnosis be made by
telemedicine?
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Economics of telemedicine
• Communication is getting faster and
cheaper
• Equipment is getting smaller (more
mobile) and cheaper
• People costs are rising
• How do we adapt?
• Who pays?
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What makes tm a success?
• Why has telemedicine caught on in
some disciplines and some places, but
not in others?
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Which is the future of health?
www.teis.nhs.uk
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