Telemedicine definition refers to the remote delivery of healthcare services and patient care via unified communication technologies. And this isn’t fiction! We have been witnessing telemedicine services turning into an efficient treatment tool that literally saves lives.
Despite the widespread belief that telemedicine is an innovation that is still little used in practice, it dates its history back to the days of telegraphs — just imagine that computers were yet to be invented. Actually, telephone consultations have something to do with this area. However, a video conferencing session for patient monitoring as a telemedicine tool was first held in 1965. It was a live surgery: Michael DeBakey, an outstanding heart surgeon, was performing an aortic valve replacement on an artificial heart.
[Bashshur, R.L., Sanders, J.H., and Shannon, G.W. (eds.) Telemedicine: Theory and Practice. Springfield: Charles C. Thomas, Publisher, Ltd., 1997. DeBakey M. Telemedicine has now come of age // Telemedicine Journal.-1995.-Vol.1,N1.] ( orig )
Telemedicine as a definition wasn’t used back in those times. It appeared in the first half of the 1970s. Nowadays, this concept is defined as one of the branches of medicine using unified communication technologies to deliver medical care to patients in remote locations and give timely medical care. What is important is that modern telemedicine services provide for two-way audio and video communication.
However, it would be wrong to believe that any video conferencing system is suitable for patient monitoring. High-quality and efficient healthcare services being delivered to patients in remote locations require a special approach to video conferencing. The more responsible an area is, the more complex technical details of telemedicine services are. Moreover, since this branch is actively developing, telemedicine laws are already being passed in different countries for regulatory purposes. For instance, when organizations implement telemedicine solutions, it is important for them not only to use high-quality and efficient equipment but also to take into account various legal nuances, e.g. personal data processing, medical security, etc.
It stands to reason that the telemedicine definition we are considering includes a wide range of tasks and solutions. In the most general terms, they are categorized into “doctor-patient” and “doctor-doctor”. In practice, there are many directions of telemedicine which can be grouped according to the main specialty criteria. The main directions include:
"Doctor—Patient" Solutions
"Doctor—Doctor" Solutions
In telemedicine, remote consultations and patient monitoring are the most common and popular telemedicine services. Thanks to specialized video conferencing systems, consultants, their assistants, and patients in remote locations can audiovisually interact with each other — they can not only see and hear each other but also share graphic and text data, e.g. a physician can receive an X-ray image of a patient, and a patient can see a medical license of a physician.
This approach is extremely convenient in all respects. For a long time, telemedicine consultations have been held out as a means to receive medical services in districts where a clinic or a certain doctor can’t be. In this case, patients don’t need to go from towns to the capital for examinations — it’s enough to contact a physician via a video conferencing system at a convenient time for both. However, this is quite a restricted approach.
Video conferencing is widely used in different telemedicine projects to provide remote medical care and clinical healthcare services. Watch this short video to learn how video conferencing can be used in different clinical case scenarios:
Today, telemedicine services are increasingly used by city dwellers who don’t have enough time to monitor their own health, make an appointment with a doctor, and much less wait in line. Instead, by using a special mobile application, you can find an available doctor at any time of the day — the application itself will recommend the best doctor in a particular field and tell you which physicians are available right now and are ready to help you. In the future, you may search for doctors like that around the world. But soon, you won’t even need to call anyone — physicians themselves will find out about your problems before you notice them.
TrueConf is a secure self-hosted HIPAA compliant platform for telemedicine. Designed to integrate with your EHR and medical devices, it provides you with the flexibility to create solutions for the most challenging telehealth cases.
Remote monitoring systems are used by medical professionals to monitor patients’ health status. This requires special telemedicine equipment which helps physicians monitor their patients in remote locations. Very often, remote monitoring is used to monitor older people who can’t carry out necessary therapeutic manipulations without assistance. Home telemedicine is especially important for patients who need regular, prompt examinations (e.g. for people with heart diseases).
The development of microelectronics technology, mobile broadband Internet access, and special software take telemedicine to the next level. For telemedicine, IoT technology comes in very handy. As a result, you can not only monitor a patient’s condition but also diagnose future problems in a potentially healthy person.
Many people are now used to wearing miniature sensors on their bodies. We are referring to various fitness trackers and other similar devices. They can not only consolidate data on your sporting achievements but also analyze important biometric parameters used to draw conclusions about the current state of your body and inform you or your doctor in case of any problems.
How can a system know that a person isn’t alright? The mentioned IoT and Big Data processing systems enter the arena. Put it simply, this is the case: a huge number of wearable biometric sensors can transmit health data to a central storage. This data is processed there and is used to draw conclusions for telemedicine systems and clinical services. Moreover, the data remains anonymous — the system knows only the physical parameters of a person (gender, age, pulse dynamics, etc.); other data that can identify a person is unknown to it. Based on statistics, it draws conclusions on the earliest symptoms of certain diseases. If a person wearing a biometric sensor develops certain symptoms, he/she may be advised to visit one or another physician.
Sometimes, doctors need help too because difficult and complex cases are quite widespread. For example, a suitably qualified doctor located in New York may not be available in a district hospital. At the same time, transporting a patient to a metropolitan clinic or a specialized medical center is impossible or impractical (due to the distance), and a doctor wouldn’t travel to a place several hundred miles away. The only way out is an urgent video call session which helps you receive the necessary advice as quickly as possible, without wasting your precious time.
Emergency consultations may also be useful for patients in remote locations, such as offshore oil rigs or foreign going ships. In this case, stable operation via relatively slow satellite communication channels plays a leading role for a telemedicine system and medical care.
Of course, we can’t ignore such a specific area of telemedicine as broadcasting live surgeries. This direction of telemedicine is used for so-called telementoring when novice or inexperienced surgeons watch a live surgery performed by a highly qualified professional. Moreover, unlike watching recordings, video conferencing systems enable you to ask questions on the go or immediately after a surgery — you can receive detailed explanations and analyze difficult points.
During surgery, physicians can share images of various medical equipment (microscope, endoscope, or surgical table) recorded by digital video cameras.
Telemetry data (patient’s blood pressure, pulse rate, etc.) can also be shared. Experience is the most important quality for surgeons. Moreover, medicine is rapidly developing in modern times, as new types of surgeries which seemed to be impossible are becoming available. This is just the beginning. But how can you quickly share your experience with the professional community all over the world? Video conferencing tools make it easier, faster, and more efficient. Who knows how many lives have already been saved by professionals who gained experience on time thanks to this approach. The prospects of telemedicine are more than clear — this direction will be actively developing for many more years.
Telemedicine is important to distance learning. Medical seminars, conferences, and lectures broadcast by a video conferencing system enable higher level professionals to share their experience not only theoretically but also practically. During lectures, professors of medical universities can organize a video call with representatives of medical institutions who can share their experience online. And this isn’t only about teaching students. It is important to share professional skills, news, discoveries, and achievements for dedicated professionals in the first place. It is unlikely that, in any small town, a local physician can attend a lecture, learn new technology and receive instructions from a world-class professional. However, video conferencing solutions can fix it — you can not only see the guru of medicine and listen to him/her (video recording is enough for this purpose) but also, which is extremely important, ask him/her important questions.
As noted above, not every video conferencing system is suitable for the types of clinical services we’ve mentioned. To take full advantage of telemedicine, a technical platform must meet certain very stringent requirements. Firstly, it is stable operation in multilateral communication as well as high quality and detail of images (especially for surgeries). Indeed, the patient’s life may depend on graphics resolution, color reproduction, and clarity of images (sometimes trifles, such as blood color shades or exact shapes of spots on X-ray images, are critical). Therefore, an efficient video conferencing system intended for telemedicine should support stable image transmission in 4K format. Modern equipment for medical services (e.g. laparoscopes, etc.) already transmits images in 3D format. Even FullHD resolution is not enough because each eye receives only 480 image lines and, without 4K support, 3D video communication doesn’t make sense. Telemedicine video conferencing systems also require multilateral voice communication with no compromise on signal quality.
However, healthcare providers should be keenly aware of the risks to confidential information as these threats may undermine patients’ trust. Many of these issues are primarily related to the way patients’ data are stored, transmitted or accessed. To avoid potential pitfalls, healthcare organizations should use solutions with strong encryption algorithms that make it impossible to reproduce confidential video or audio streams even if they are intercepted. Individual device security should also be a high priority because in many cases, criminals access patients’ data by exploiting such vulnerabilities, weak passwords or lack of proper anti-virus software. Multi-factor authentication and regular auditing might be critical for closing such loopholes.
TrueConf Server, a video conferencing system, implements all the features we’ve listed. This solution is perfect for video conferencing both in private networks and via the Internet.
Moreover, it excellently solves all relevant tasks in modern telemedicine for clinical services. Thanks to the support for UltraHD video conferencing and 3D video communication, medical staff can zoom in on any image to the fullest degree, e.g. during live surgeries or remote examinations. TrueConf applications support images in DICOM format, a medical standard to store and transmit digital images and patient documents.
