TELEMEDICINE can be broadly defined as the use of telecommunications technologies to provide medical information and services. Although this definition includes medical uses of the telephone, facsimile, and distance education,telemedicineis increasingly being used as shorthand for remote electronic clinical consultation. Interest in the field has increased dramatically in the 1990s. State and federal allocations for telemedicine and related technologies are likely to exceed $100 million in fiscal 1994-1995.1At least 13 federal agencies, including the US Department of Commerce, Health Care Financing Administration (HCFA), Office of Rural Health Policy, and US Department of Defense, have begun telemedicine research and demonstration programs. Many states are using their own resources to build state-of-the-art telemedicine systems, some with capital investments exceeding $50 million. Faith in this technology is not universal, however. Depending on one's viewpoint, telemedicine may be seen as a valuable tool for providing badly needed specialty care services

https://jamanetwork.com/journals/JAMA/articlepdf/386892/jama_273_6_037.pdf

Telemedicine Technology and Clinical Applications

Telemedicine is the delivery of health care and the exchange of health-care information across distances. It is not a technology or a separate or new branch of medicine. Telemedicine episodes may be classified on the basis of: (1) the interaction between the client and the expert (i.e. realtime or prerecorded), and (2) the type of information being transmitted (e.g. text, audio, video). Much of the telemedicine which is now practised is performed in industrialized countries, such as the USA, but there is increasing interest in the use of telemedicine in developing countries. There are basically two conditions under which telemedicine should be considered: (1) when there is no alternative (e.g. in emergencies in remote environments), and (2) when it is better than existing conventional services (e.g. teleradiology for rural hospitals). For example, telemedicine can be expected to improve equity of access to health care, the quality of that care, and the efficiency by which it is delivered. Research in telemedicine increased steadily in the late 1990s, although the quality of the research could be improved--there have been few randomized controlled trials to date.

Introduction to the Practice of Telemedicine

100 years of telemedicine

Although hard to believe, this year we celebrate the 100th anniversary of telemedicine. The term telemedicine was coined in the 1970s by the American Thomas Bird and, literally translated, means “healing at a distance” (from Latin “medicus” and Greek “tele”). However, the origins of this evolving technology date back to the early 20th century, when Willem Einthoven, a Dutch physiologist, developed the first electrocardiograph in his laboratory in Leiden. With the use of a string galvanometer and telephone wires, he recorded the electrical cardiac signals of patients in a hospital 1½ km away. He stated: “Where there is a link, actual and figurative, between laboratory and hospital, and collaboration between physiologist and clinician, each remaining master in his territory, there one may fruitfully utilize these new electrical methods of research”. Einthoven’s electrocardiograph was very large but over the years was transformed into a mobile or even portable monitoring device. Nevertheless, he can be regarded as the first clinician scientist to develop and systematically apply a technique that is very similar to telemedicine in the modern sense. The results of his experiments were published in 1906.1 During the 1920s, Norwegian doctors provided advice for sick ship crew members at sea via radio link. In 1967, Bird and colleagues established an audiovisual microwave circuit between the Massachusetts General Hospital in Boston, USA, and the nearby Logan Airport. They conducted and evaluated >1000 medical consultations for airport employees and travellers who were ill.2 Since then, the number of scientific studies relating to telehealth has steadily increased, and many countries have launched their own electronic health (e-health) programmes, which combine medical informatics, public health and business. Telemedicine constitutes a small part of e-health and is particularly suitable for large geographical areas with a sparse, underserved population. Examples are …

/pdf/one-hundred-years-of-telemedicine-does-this-new-technology-4sfh4mhcer.pdf

One hundred years of telemedicine: does this new technology have a place in paediatrics?

This paper aims to examine how health telematics will develop in the first 10 years of the new millennium and, in particular, to assess what operational, ethical and legal barriers may lie in the way of this development. A description of the key principles and concepts involved in telemedicine and a short historical overview of telemedicine's evolution over the past century are followed by consideration of why empirical research into 'info-ethics' and other deontological and legal issues relating to telemedicine is being necessarily catalysed by, amongst others, the European Commission. Four evolving health telematics applications are examined in some detail: electronic health records; the transmission of visual media in disciplines such as teleradiology, teledermatology, telepathology and teleophthalmology; telesurgery and robotics and the use of call centres and decision-support software. These are discussed in the light of their moral, ethical and cultural implications for clinicians, patients and society at large. The author argues that telemedicine presents unique opportunities for both patients and clinicians where it is implemented in direct response to clear clinical needs, but warns against excessive reliance upon technology to the detriment of traditional clinician-patient relationships and against complacency regarding the risks and responsibilities - many of which are as yet unknown - that distant medical intervention, consultation and diagnosis carry.

https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2796.2001.00699.x

Telemedicine: barriers and opportunities in the 21st century.

A request is received from a consumer of services to consult with a service provider having a service provider profile that satisfies at least some attributes in a set of attributes that define a suitable service provider; an available service provider satisfying at least some of the attributes in the set of attributes is identified; and a communication channel is provided to establish a communication between the consumer of services and the identified service provider.

Connecting Consumers with Service Providers

Telediagnosis: a new community health resource. Observations on the feasibility of telediagnosis based on 1000 patient transactions.

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Telediagnosis: a new community health resource. Observations on the feasibility of telediagnosis based on 1000 patient transactions.