Approaches to telemedicine

Resumen

Information technologies have become essential for most businesses, including those in the healthcare industry (Chau & Hu, 2004; Rodger & Pendharkar, 2000). Information technologies can improve both the delivery of the healthcare service and certain aspects of healthcare centers’ administration. There has been a proliferation of information systems applied to the health sector, such as hospital information systems, medical decision-support systems, systems for interpreting medical tests and images, expert systems based on the handling of medical knowledge, or telemedicine (Rao, 2001). Etymologically, the term telemedicine means medicine from a distance. This concept can include something as simple as two healthcare professionals debating the case of a patient by telephone, or as complex as conducting the diagnosis of a patient remotely using videoconference. Telemedicine implies that there is an exchange of information, without personal contact, between two physicians or between a physician and a patient. Thanks to telecommunications technologies, telemedicine enables the provision of healthcare services or the exchange of healthcare information across geographic, temporal, social, and cultural barriers (Chau & Hu, 2004). Telemedicine makes use of a wide range of technologies to overcome distances, such as radio, analog landlines, e-mail, the Internet, ISDN, satellites,telesensors, and so forth, for the transmission of medical information, (data, voice, and video) and provision of medical services from a distance. With regard to the transmission of medical information, this includes the digital handling of patient information (for example, from their electronic medical records), or the transfer of images (such as radiographs, high-resolution medical images, computer tomography scans, magnetic resonance imaging pictures, ultrasound images, electrocardiograms or echocardiograms, video images of endoscopic cameras, etc.) or sounds (for example, from electronic stethoscopes) (Rao, 2001). With regard to the provision of remote medical services, specialist physicians can see their patients in consultation, conduct medical examinations, arrive at a diagnosis and prescribe treatment, all without needing to be in actual physical contact with them. The essence of telemedicine is to move the medical knowledge and experience rather than move the patient physically. For this, telemedicine involves rather more than just taking medical services to where they did not exist before. It has also become a practice of transmitting and handling knowledge. It enables medical practitioners to exchange their knowledge (Robinson, Savage & Campbell, 2003) so that others can apply it in specific situations. We should not confuse telemedicine with e-health (or tele-health). Telemedicine only refers to the provision of medical services. E-health, on the other hand, refers to both medical services and any other type of service, as long as it has something to do with health and employs information technology. In this respect, e-health would also include healthcare educational activities, research in the health sciences, the handling of electronic files in the healthcare system, and any other use of information technologies in the healthcare system. The rest of this article is organized as follows. The second section discusses the antecedents of telemedicine, and proposes two taxonomies, one in function of the temporal synchronization of the individuals using it, and the other in function of the medical specialty for which it is employed. The third section tries to identify the obstacles in the way of an adequate acceptance and development of telemedicine. Before the conclusions section, section four suggests some future trends, including what technologies are most in use at present and which ones are promising for the future.