Telemedicine

Photo: Andy G

A common theme in any discussion related to health care today is the major challenges it faces with access, equity, cost and quality in both developed and developing countries. Although technological advances have led to increased life expectancy but these gains have led to an ever increasing demand for health services due to chronic diseases. Modern information and communication technologies such as computers, the Internet and mobile phones revolutionise communication appear to have great potential to help address global health challenge

s by using them appropriately to address healthcare problems.

Cochrane Library describes telemedicine as a division of telehealth that uses communication and information technologies to enable delivery of healthcare where the individuals involved are in different locations. Communication is realised either between health professionals or between a health professional and a patient. There are three main categories of telemedicine applications: store-and-forward, remote monitoring and interactive telemedicine.

  • Store and forward telemedicine combines data gathering and transmission of vital medical data from a patient to a health professional for review at a later time (time shifting).
  • Remote monitoring involves medical devices that monitor patients from home (location shifting).
  • Interactive telemedicine enables real-time remote consultations via technologies such as videoconferencing and telephones (location shifting).

Global telemedicine market is forecasted  to grow at a CAGR of 19% during 2010 to 2015 according to Technavio and to reach $13.9bn by 2012  according to BCC Research. In particular, Africa, Europe and the Middle East are anticipated to be the dominant players with 35.82% of the global share.  Many mergers and acquisitions have taken place the last years as it is considered a profitable field and there is a rising demand for telemedicine services, especially in Europe. Leading corporations that offer telemedicine solutions involve CiscoPolycomLifesize by Logitech, Tandberg (recently acquired by Cisco), AMD and Radiant.

The advantages that interactive telemedicine offers are numerous and could undoubtedly benefit both the developed and developing nations. Interactive telemedicine :

  • enhances the timeliness of treatment as it uses real-time teleconsultations. (e.g. 3G doctors and ScriptPro )
  • eliminates the borders of care as it enables delivery of treatment even in the most remote areas. For example, Aravind Eye Hospital in India has established a telemedicine network that uses satellite and internet-based telecommunication links to enable access to eye care to patients that live in rural areas at any time. Results of this installation have been remarkable. In just over two years since its inception approximately 90, 000 teleconsultations were performed and restored the vision of 15,858 patients that otherwise would have remained untreated.
  • facilitates collaboration among health professionals and therefore it has the potential to improve health outcomes. Another example in India is Narayana Hrudayalaya (NH) cardiac care centre which organises cardiac care units at remote districts of India which are supplemented by a tele-link service whenever the local experts need to refer back to the hospital for second opinion for a difficult case.
  • could contribute to the health cost containment effort of the governments as it seems to reduce unnecessary admissions and to eliminate travel costs.

So far, the field has moved forward in small steps instead of leaps because there is significant installed base and incumbent lock-in as far as status quo is concerned. There are now increasing signs that even the most die-hard and heavily unionised systems are unable to ignore the potential  benefits of telemedicine. We should expect to see increased adoption of telemedicine technologies and service paradigms which utilise resources better than the current face to face and geographically delimited model.