Advances in wireless video technology and Internet communications are just what the doctor ordered for telemedicine's leap toward ubiquity. Higher image quality, shorter latency times, faster transmission speeds, and improvements in information-technology medical databases now make it practical to administer long-distance clinical healthcare, patient and professional education, and health administration.
With telemedicine, doctors can provide diagnostic and therapeutic services to patients in remote locations. A nurse or medical technician examines the patient and transmits information, e.g., vital signs, via a two-way communications link. The doctor at the other end of the link reviews the data, as well as audio and video of the patient, to determine the necessary treatment.
During last year's American Telemedicine Association convention in Denver, Colo., the Telemedicine and Advanced Technology Research Center (TATRC) demonstrated telesurgery. A surgeon at one location remotely controlled a robot that performed the actual surgery on a patient at another location. TATRC is part of the U.S. Army's Research and Materials command. Intuition Surgical Inc., the U.S. Army's Walter Reed Medical Center, Johns Hopkins University, and the University of Cincinnati also contributed to the research.
Still, most of today's telemedicine applications are relatively primitive. They typically involve the transfer of medical images and data into a database that's instantly accessible for medical services providers. The most common application is teleradiology, which is the transmission of X-rays, CT scans, and MRIs. Telepathology involves sending images of pathology slides for diagnostic consultations. In teledermatology, specialists can remotely examine digital images of a patients' skin.
Many physicians already use the Web to research diagnoses for obscure diseases. For example, doctors can access U.K.-based Isabel Healthcare's Web-based Isabel database, which has over 10,000 diagnoses.-Doctors need only enter the patient's symptom information, and the database provides appropriate potential diagnoses.
Wireless Devices Help
With wireless technology, patients can avoid visits to the doctor's office for routine and preventative healthcare tasks. These examinations are just as effective and less expensive than doctor visits. "Telemedicine light" often only needs a PDA, a notebook computer, or even a properly equipped cell phone.
Vitaphon's model 2300 looks like an ordinary cell phone. But with its four sensor buttons, patients can hold it to their chest and record an electrocardiogram (ECG) that could be sent to a doctor or medical center. Emergency personnel can even use the phone's GPS signal to locate the patient.
CardioNet came up with a two-part system that monitors patients for arrhythmia. Patients wear a three-lead sensor as a pendant or on their belt. This sensor records two channels of ECG and constantly communicates with the second device, the CardioNet monitor. Patients carry this Palm Pilot-like device in their pocket or purse. When the sensor detects an arrhythmic event, the monitor automatically transmits the ECG to the local CardioNet Center. Personnel there respond to the report and execute the appropriate medical attention.
Korean company Healthpia embeds glucose-monitoring electronics into cell phones for diabetics. The user inserts a diabetes test strip into the phone, which then sends blood-sugar information to a medical practitioner. Along the same lines, Switzerland-based Card Guard has a line of wireless devices that transmit the patient's blood pressure, blood oxygen levels, and weight to a health-monitoring center.
Even Microsoft is getting into the act. Its researchers have developed software that interconnects inexpensive physiological monitors to smart phones via Bluetooth transmissions.
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